NPIMap

Organization Active NPI

Bridges Habilitation Services, Inc.

Doing business as Bridges

  • Specialist
  • Evanston, WY
National Provider Identifier
1699299313
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BRIDGES HABILITATION SERVICES, INC.
Doing business as
Bridges
Practice address
1425 Highway 150 S Ste 2
Evanston, WY 82930-5377
Phone
(307) 789-0664
Fax
(307) 222-0614
NPI assigned
Aug 3, 2017
Last updated
Aug 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Authorized official

Name
David M CanenNPI 1861729667
Title
Ceo
Phone
(307) 789-0664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

1425 Highway 150 S Ste 2
Evanston, WY 82930-5377

Mailing address

PO Box 1642
Evanston, WY 82931-1642
Phone (307) 789-0664

Other identifiers 1

IdentifierTypeStateIssuer
115726400MedicaidWY

Other names 1

  • Bridges Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bridges3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1699299313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1642",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829311642",
            "telephone_number": "307-789-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HIGHWAY 150 S STE 2",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305377",
            "telephone_number": "307-789-0664",
            "fax_number": "307-222-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES HABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "CANEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-789-0664"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115726400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridges",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.