Kelly Marie Bridgham

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

NA Issued in PA

Practice address

925 Chestnut St FL 6
Philadelphia, PA 19107-4204

Phone

(215) 955-6760

Fax

(215) 503-3736

NPI assigned

Apr 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1821739251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST FL 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074204",
            "telephone_number": "215-955-6784",
            "fax_number": "215-923-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST FL 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074204",
            "telephone_number": "215-955-6760",
            "fax_number": "215-503-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGHAM",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridge Support Coordination Services
• Bridgecare Medicine LLC
• Amy Bridgeman, M.D.
• Bridges to Greater Grace Foundation
• Michael R Bridges, PH.D.
• Natalia Bridy
• Lindsey Brier, MD, PHD
• Nora Brier, PSY.D.
• Erica Leigh Brigati, RD
• Briggs at Home Health Care LLC

• Otolaryngology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Otolaryngology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.