Bridges of Hope Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

MHL096269 Issued in NC

Legal business name

BRIDGES OF HOPE INC

Practice address

2303 Wellington Dr SW Ste D
Wilson, NC 27893-8620

Phone

(252) 360-4142

Fax

(252) 565-0301

NPI assigned

Sep 29, 2010

Last updated

Nov 17, 2023By 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

Amanda Willett

Title

Ceo

Phone

(252) 258-8632

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bridges of Hope, Inc.

  • Community/Behavioral Health Agency
  • Greenville, NC
  • NPI 1568509073

  O20091104000110

  Same enrollment

Locations

Practitioners 5

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.

• Tracey Lee Smith, PA-C

  • Physician Assistant
  • Greenville, NC
  • NPI 1790107357
  Medicare reassignment NPD
• Kathy D Mayo, MD

  • Psychiatry Physician
  • Greenville, NC
  • NPI 1548372949
  NPD (past)
• Scott McClelland, DO

  • Psychiatry Physician
  • Rocky Mount, NC
  • NPI 1861484230
  NPD (past)
• Tony Patrick McKee, LCSW

  • Clinical Social Worker
  • Greenville, NC
  • NPI 1275612517
  NPD (past)
• Whitney Jo Dennison Bakken, MD

  • Psychiatry Physician
  • Lancaster, PA
  • NPI 1275738890
  NPD (past)

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1801105408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 WELLINGTON DR SW STE D",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938620",
            "telephone_number": "252-360-4142",
            "fax_number": "252-565-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 WELLINGTON DR SW STE D",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938620",
            "telephone_number": "252-360-4142",
            "fax_number": "252-565-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES OF HOPE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "WILLETT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-258-8632"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NC",
            "license": "MHL096269",
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NC",
            "license": "MHL098191",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NC",
            "license": "MHL053078",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303078",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brentwood Clinic, P.a.
• Douglas C Brewer, MD
• Jo Ann Brewer, RN,FNP
• Stacy Brewer, LMBT
• Edward Sharp Brezina Jr., M.D.
• Amanda Bray Brinson, CPNP
• Katelyn Craft Britt, MSW, LCSW
• Britthaven, Inc. (Britthaven of Wilson)
• Andrea Brooks, FNP-C
• Janelle Brown Taft, MSN, FNP-C

• Multi-Specialty Clinic/Center in Wilson, NC
• Providers in Wilson, NC by specialty
• Multi-Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.