NPIMap

Individual provider Active NPI

Bridget Lynn Gresback, NP

  • Pediatric Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1831786714
Registry record updated Jan 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C-APN.0004674-C-NP Issued in CO
Practice address
2317 Memorial Pkwy SW Ste 410
Huntsville, AL 35801-5623
Phone
(256) 517-8861
Fax
(256) 517-8872
NPI assigned
Dec 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X C-APN.0004674-C-NP CO Primary
Family Nurse Practitioner 363LF0000X 1-181042 AL

Addresses

Primary practice location

2317 Memorial Pkwy SW Ste 410
Huntsville, AL 35801-5623

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Other names 1

  • Bridget Lynn Loucks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220215002757 AL Practitioner - Nurse Practitioner 7517372048 Reassigns benefits to 1 organization
I20230222003111 CO Practitioner - Nurse Practitioner 7517372048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Children'S Hospital Colorado Hospital, Aurora, CO, CCN 063301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-181042ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urogynecology Center of Huntsville, P.C. CurrentSince Jan 1, 2022 Accepting new patients
University Physicians Incorporated Nurse Practitioner CurrentSince Mar 1, 2023 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Mar 1, 2023 Accepting new patients
University Physicians, Incorporated Past Accepting new patients

Locations

420 Lowell Dr SE
Ste 103
Huntsville, AL 35801
Phone (256) 535-5940

2317 Memorial Pkwy SW
Ste 410
Huntsville, AL 35801
Phone (256) 517-8861

13123 E 16th Ave
Ste B130
Aurora, CO 80045

1635 Aurora Ct
Fl 3
Aurora, CO 80045
Phone (720) 848-1060

13100 E Colfax Ave
Aurora, CO 80011
Phone (720) 777-7468

1635 Aurora Ct
Fl B198
Aurora, CO 80045

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

469 State Highway 7
Broomfield, CO 80023
Phone (720) 478-5000

Dept 1061
Denver, CO 80256

1811 Plaza Dr
Highlands Ranch, CO 80129
Phone (720) 478-0108

Interoperability endpoints

  • Direct secure messaging: bgresback261800@direct.childrenscolorado.org

Organizations & group practices 5

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

Hospital & facility affiliations 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674345600000",
    "number": "1831786714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 MEMORIAL PKWY SW STE 410",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015623",
            "telephone_number": "256-517-8861",
            "fax_number": "256-517-8872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRESBACK",
        "first_name": "BRIDGET",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2023-01-22",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "C-APN.0004674-C-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-181042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "LOUCKS",
            "middle_name": "LYNN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.