Keith Mycal Bridges

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1126443 Issued in TX

Practice address

11801 South Fwy
Burleson, TX 76028-7021

Phone

(817) 293-9110

NPI assigned

Feb 19, 2021

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Assists, LLC

  • Nurse Practitioner
  • Mansfield, TX
  • NPI 1295627842

  Single Specialty

  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Texas Health Huguley, Inc

  dba Texas Health Huguley Hospital Fort Worth South

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1518355759
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Texas Health Huguley Hospital Fort Worth South

  • General Acute Care Hospital
  • Burleson, TX
  • NPI 1033120423
  Care Compare affiliation
• Texas Health Huguley, Inc.

  dba Huguley Memorial Medical Center

  • Psychiatric Hospital Unit
  • Burleson, TX
  • NPI 1548273881
  Care Compare affiliation

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1811580814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 HARTMAN CIR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Lone Star Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760638744",
            "country_code": "US",
            "telephone_number": "682-341-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "KEITH",
        "middle_name": "MYCAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1126443",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "895421",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Renee Bravo, NP
• Payton Breaux
• Edward A Breeding III, D.C.
• Steven David Bresnahan, O.D.
• Brian J Gengler, MD PLLC (Brian J Gengler, MD)
• Brite Dental of Burleson PA
• Raisa Nguyen Broadwell, MD
• Dominique Brodnax, PT, DPT
• Jackayla Faith Brooks, BCB
• Macy Browder

• Family Nurse Practitioner in Burleson, TX
• Providers in Burleson, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.