Organization Active NPI

Bridgeway Therapeutics Inc

  • Adult Mental Health Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1720680440
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BRIDGEWAY THERAPEUTICS INC
Practice address
2610 E 32ND St Ste 1
Minneapolis, MN 55406-1905
Phone
(612) 361-7727
Fax
(612) 454-2693
NPI assigned
Nov 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Fatma Abdille
Title
Ceo
Phone
(612) 361-7727

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

2610 E 32ND St Ste 1
Minneapolis, MN 55406-1905

Mailing address

2610 E 32ND St Ste 1
Minneapolis, MN 55406-1905
Phone (612) 361-7727

Other practice location 1

6001 78th Ave N
Brooklyn Park, MN 55443-2909
Phone (612) 361-7727

National Provider Directory

National Provider Directory

Locations

6001 78th Ave N
Minneapolis, MN 55443
Phone (612) 703-3237

2610 E 32nd St
Ste 1
Minneapolis, MN 55406
Phone (612) 361-7727

2833 13th Ave S
Ste 127
Minneapolis, MN 55407

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1720680440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 E 32ND ST STE 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061905",
            "telephone_number": "612-361-7727",
            "fax_number": "612-454-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 E 32ND ST STE 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061905",
            "telephone_number": "612-361-7727",
            "fax_number": "612-454-2693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 78th Ave N",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554432909",
            "country_code": "US",
            "telephone_number": "612-361-7727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGEWAY THERAPEUTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "ABDILLE",
        "authorized_official_first_name": "FATMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-361-7727"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.