Health Bridge Newport

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

ND-145 Issued in CA

Legal business name

HEALTH BRIDGE NEWPORT

Practice address

20072 SW Birch St
Suite 240
Newport Beach, CA 92660-0794

Phone

(949) 715-9321

Fax

(310) 300-0306

NPI assigned

Mar 28, 2016

Last updated

Mar 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gina Nick Cushman, MDNPI 1396108130

Title

Owner

Phone

(949) 715-9321

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gina Nick Cushman, NMD

  • Internal Medicine Physician
  • Newport Beach, CA
  • NPI 1396108130
  Authorized official Same address or phone

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1699137737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20072 SW BIRCH ST",
            "address_2": "SUITE 240",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600794",
            "telephone_number": "949-715-9321",
            "fax_number": "310-300-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20072 SW BIRCH ST",
            "address_2": "SUITE 240",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926600794",
            "telephone_number": "949-715-9321",
            "fax_number": "310-300-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH BRIDGE NEWPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "CUSHMAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-715-9321",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "CA",
            "license": "ND-145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychoanalyst in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Psychoanalyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.