Bridgeport Medical Clinic PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MD00041157 Issued in WA

Legal business name

BRIDGEPORT MEDICAL CLINIC PLLC

Practice address

511 10TH Ave SE
Puyallup, WA 98372-3875

Phone

(253) 845-7566

NPI assigned

Oct 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Jooyoung Kim, M.D.NPI 1669586087

Title

Member

Phone

(253) 797-9234

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Dennis Jooyoung Kim, M.D.

  • Internal Medicine Physician
  • Puyallup, WA
  • NPI 1669586087
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1982855995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 S 295TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980033659",
            "telephone_number": "253-797-9234",
            "fax_number": "253-588-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 10TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723875",
            "telephone_number": "253-845-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "JOOYOUNG",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "253-797-9234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MD00041157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Drew Brenden
• Erin Williams Brenner, DPT
• Shawnda L Brese, MA, LMFT
• Earl Edward Brewer, BS-PHYSIAL THERAPY
• Katherine H Brewer, M.D.
• Branden Luann Brinar, MASSAGE THERAPIST
• Laura Elizabeth Brinkman
• Brinkopf & Yant Psychiatric Services, PLLC
• Katrina Brinkopf, DNP, ARNP, PMHNP-BC
• Karen Kay Briskey, LMT, LAMT, SAMT

• Clinic/Center in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.