NPIMap

Organization Active NPI

Bridgeway Agency, LLC

  • Behavior Analyst
  • Melrose, FL
National Provider Identifier
1962156281
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRIDGEWAY AGENCY, LLC
Doing business as
BridgeWay Agency, LLC
Practice address
4511 NE County Road 219a
Melrose, FL 32666-6027
Phone
(352) 727-9304
NPI assigned
Feb 6, 2022
Last updated
May 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Authorized official

Name
Kassandra Bryan, BCBANPI 1235749599
Title
Owner/Bcba
Phone
(352) 727-9304

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

4511 NE County Road 219a
Melrose, FL 32666-6027

Mailing address

4511 NE County Road 219a
Melrose, FL 32666-6027
Phone (352) 727-9304

Other names 1

  • BridgeWay Agency, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1644105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1962156281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 NE COUNTY ROAD 219A",
            "city": "MELROSE",
            "state": "FL",
            "postal_code": "326666027",
            "telephone_number": "352-727-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 NE COUNTY ROAD 219A",
            "city": "MELROSE",
            "state": "FL",
            "postal_code": "326666027",
            "telephone_number": "352-727-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-06",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "KASSANDRA",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "352-727-9304",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BridgeWay Agency, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose, FL

Sources for this page

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