NPIMap

Organization Active NPI

Bridgeway Center Inc

  • General Practice Physician
  • Fort Walton Beach, FL
National Provider Identifier
1912119231
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BRIDGEWAY CENTER INC
Practice address
137 Hospital Drive
Fort Walton Beach, FL 32548
Phone
(850) 833-7400
Fax
(850) 833-7434
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Bonnie R Barlow
Title
Chief Executive Officer
Phone
(850) 833-3975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

137 Hospital Drive
Fort Walton Beach, FL 32548

Mailing address

137 Hospital Drive
Fort Walton Beach, FL 32548
Phone (850) 833-7400

Other identifiers 1

IdentifierTypeStateIssuer
Z134KOtherBCBS

National Provider Directory

National Provider Directory
Tax ID family
Bridgeway Center Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1912119231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HOSPITAL DRIVE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32548",
            "telephone_number": "850-833-7400",
            "fax_number": "850-833-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 HOSPITAL DRIVE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32548",
            "telephone_number": "850-833-7400",
            "fax_number": "850-833-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "BARLOW",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "850-833-3975"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Z134K",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.