Active NPI
Bridgette Wilson
- Case Manager/Care Coordinator
- Trumann, AR
National Provider Identifier
1760820773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1704 Hwy 69
Trumann, AR 72472 - Phone
- (870) 933-6886
- Fax
- (870) 933-9395
- NPI assigned
- Jun 12, 2013
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1704 Hwy 69
Trumann, AR 72472
Mailing address
1815 Pleasant Grove Road
Jonesboro, AR 72404
Phone (870) 933-6886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370995200000",
"number": "1760820773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE ROAD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "72404",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 HWY 69",
"city": "TRUMANN",
"state": "AR",
"postal_code": "72472",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRIDGETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-12",
"last_updated": "2013-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumann, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.