Organization Active NPI

Jimac LLC

Doing business as The Bridge Healthcare

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1912636630
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
JIMAC LLC
Doing business as
The Bridge Healthcare
Practice address
10828 W Elm St
Phoenix, AZ 85037-1091
Phone
(602) 561-4951
NPI assigned
Jun 8, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
John John MarcusNPI 1285363994
Title
Program Director
Phone
(602) 561-4951

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Counseling Psychologist 103TC1900X
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X
Behavior Analyst 103K00000X Primary
Assistant Behavior Analyst 106E00000X
Behavior Technician 106S00000X

Addresses

Primary practice location

10828 W Elm St
Phoenix, AZ 85037-1091

Mailing address

10828 W Elm St
Phoenix, AZ 85037-1091
Phone (602) 561-4951

Other names 1

  • THE BRIDGE HEALTHCARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1912636630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10828 W ELM ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371091",
            "telephone_number": "602-561-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10828 W ELM ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371091",
            "telephone_number": "602-561-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "602-561-4951"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE BRIDGE HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.