Bridgett Ann Wekenborg, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2012030997 Issued in MO

Practice address

404 N Keene St
Dc608.00
Columbia, MO 65201-6626

Phone

(573) 771-4265

Fax

(573) 219-4292

NPI assigned

Sep 27, 2012

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

Other identifiers 1

Other names 1

• Bridgett Ann Gildehaus Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

University of Missouri, Columbia School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Regional Health ServicesGroup PAC ID 8921917352, 165 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwekenborg453277@direct-ehr-ssmhc.com

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.

• SSM Regional Health Services

  • Clinic/Center
  • Jefferson City, MO
  • NPI 1396782587
  Medicare reassignment Care Compare group NPD
• SSM Regional Health Services

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1922119726
  NPD
• SSM Regional Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jefferson City, MO
  • NPI 1053368159
  NPD (past)

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1912258195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "address_2": "DC608.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-771-4265",
            "fax_number": "573-219-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "address_2": "DC608.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-771-4265",
            "fax_number": "573-219-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEKENBORG",
        "first_name": "BRIDGETT",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2012030997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912258195",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETT",
            "last_name": "GILDEHAUS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sydney Weirich, DPT
• Angela Rose Weis, PT
• Cody Weisel, MD
• Ethan David Weiss
• John Weitlich, M.D.
• Amy Danielle Welch, PHARM D
• Benjamin Leo Welch
• Charles Eli Welch, M.D.
• Ethan Welch, MD
• Justin Luke Welch, MD

• Pediatric Nurse Practitioner in Columbia, MO
• Providers in Columbia, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.