Bridgeport Express Care Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BRIDGEPORT EXPRESS CARE INC

Practice address

1370 Johnson Ave FL 1
Bridgeport, WV 26330-1492

Phone

(304) 842-3330

Fax

(304) 842-3303

NPI assigned

Dec 4, 2008

Organization subpart

No

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

Authorized official

Name

Timothy Peasak, DONPI 1720142391

Title

President

Phone

(304) 842-3330

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy M Peasak, D.O.

  • Emergency Medicine Physician
  • Bridgeport, WV
  • NPI 1720142391
  Medicare reassignment Care Compare group NPD Authorized official
• Natalie R King-Selario, DO

  • Family Medicine Physician
  • Bridgeport, WV
  • NPI 1225214240
  Medicare reassignment Care Compare group NPD
• David P. Peasak II, MSN, NP

  • Nurse Practitioner
  • Morgantown, WV
  • NPI 1316987001
  Medicare reassignment Care Compare group NPD
• Maria Bridgette Scudere, NP-C

  • Family Nurse Practitioner
  • Bridgeport, WV
  • NPI 1962036509
  Medicare reassignment Care Compare group NPD
• Travis Lee Wamsley, FNP-BC

  • Nurse Practitioner
  • Morgantown, WV
  • NPI 1295406833

  Single Specialty

  Medicare reassignment NPD
• Landyn Paige Bonamico

  • Physician Assistant
  • Bridgeport, WV
  • NPI 1801514658
  Medicare reassignment
• Jamie Leigh Collins, PA-C

  • Physician Assistant
  • Philippi, WV
  • NPI 1336475557
  Medicare reassignment
• Justin Goff, PA-C

  • Physician Assistant
  • Bridgeport, WV
  • NPI 1699420125
  Medicare reassignment
• Ned A Hess Jr., PAC

  • Physician Assistant
  • Shinnston, WV
  • NPI 1265493100
  Medicare reassignment
• Cristobal N Rivera, PA-C

  • Physician Assistant
  • Franklin, WV
  • NPI 1427150598
  Medicare reassignment
• Monica Lynn Shaffer, PA-C

  • Physician Assistant
  • Philippi, WV
  • NPI 1902034606
  Medicare reassignment
• Tammy Lou Yazevac, PA

  • Physician Assistant
  • Bridgeport, WV
  • NPI 1750674149
  Medicare reassignment

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1912142001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 JOHNSON AVE FL 1",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301492",
            "telephone_number": "304-842-3330",
            "fax_number": "304-842-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 JOHNSON AVE FL 1",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301492",
            "telephone_number": "304-842-3330",
            "fax_number": "304-842-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT EXPRESS CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "PEASAK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-842-3330",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810013952",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Leeanne Brammer, M.A., CCC-SLP
• Justin Michael Brewer, MMS, ATC, PA-C
• Bridgeport Behavioral Clinic
• Bridgeport Behavioral Medicine
• Bridgeport Center LLC
• Bridgeport Family Chiropractic
• Bridgeport Health Care Center, LLC
• Bridgeport Pharmacy Inc
• Bridgeport Physical Therapy Services, Inc.
• Bridgeport Physical Therapy Services, Inc.

• General Practice Physician in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• General Practice Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.