Mitchell Ryan Bridgeford, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2264 Issued in ND

Practice address

15 8TH Ave N
Eden Prairie, MN 55343-7670

Phone

(529) 933-5085

NPI assigned

Jun 19, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Active Therapy MNGroup PAC ID 2769878099, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Active Therapy MN

  • Physical Therapist
  • Eden Prairie, MN
  • NPI 1730835257
  Medicare reassignment Care Compare group NPD
• Lelwica Chiropractic

  • Chiropractor
  • Pequot Lakes, MN
  • NPI 1780851030

  Physical Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1659931723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 8TH AVE N",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553437670",
            "telephone_number": "529-933-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 8TH AVE N",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553437670",
            "telephone_number": "529-933-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Lorrain Dr",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585030311",
            "country_code": "US",
            "telephone_number": "701-323-1330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 8th Ave N",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553437670",
            "country_code": "US",
            "telephone_number": "529-933-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGEFORD",
        "first_name": "MITCHELL",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Breeggemann
• Jordan Breidenbach
• Riley Bren
• Sienna Brewington
• Amy Elizabeth Brice, MD
• Bright Horizons Autism Center
• Bright Minds Therapy Center LLC
• Bright Pathways LLC
• Brighton Health Services LLC
• Kevin John Bril, D.D.S.

• Physical Therapist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.