Active NPI
Bridgid S Wiredu, CRNP
- Nurse Practitioner
- Suitland, MD
National Provider Identifier
1649487331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R124115
- Practice address
- 5100 Auth Way
Suitland, MD 20746-4207 - Phone
- (301) 702-5000
- Fax
- (301) 702-5114
- NPI assigned
- May 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R124115 | MD | Primary |
Addresses
Primary practice location
5100 Auth Way
Suitland, MD 20746-4207
Mailing address
2101 E Jefferson St
Rockville, MD 20852-4908
Phone (301) 816-6660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200928000035 | DE | Order and Referring Only - Nurse Practitioner | 6103720818 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649487331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 E JEFFERSON ST",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208524908",
"telephone_number": "301-816-6660",
"fax_number": "301-816-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5100 AUTH WAY",
"city": "SUITLAND",
"state": "MD",
"postal_code": "207464207",
"telephone_number": "301-702-5000",
"fax_number": "301-702-5114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIREDU",
"first_name": "BRIDGID",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R124115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suitland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.