Organization Active NPI

Bridgeway Health Solutions

  • Obstetrics & Gynecology Physician
  • Tempe, AZ
National Provider Identifier
1992000764
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1283 Issued in AZ
Legal business name
BRIDGEWAY HEALTH SOLUTIONS
Practice address
1501 W Fountainhead Pkwy
Suite 201
Tempe, AZ 85282-1868
Phone
(866) 475-3129
Fax
(866) 687-0515
NPI assigned
Jan 25, 2011
Organization subpart
Yes
Parent organization
CENTENEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Authorized official

Name
Nicole Larson, VP,
Title
Compliance Officer
Phone
(866) 475-3129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 1283 AZ Primary

Addresses

Primary practice location

1501 W Fountainhead Pkwy
Suite 201
Tempe, AZ 85282-1868

Mailing address

1501 W Fountainhead Pkwy
Suite 201
Tempe, AZ 85282-1868
Phone (866) 475-3129

Other identifiers 1

IdentifierTypeStateIssuer
231241MedicaidAZ

Other names 1

  • Centene Corporation Other name

National Provider Directory

National Provider Directory

Locations

1501 W Fountainhead Pkwy
Ste 201
Tempe, AZ 85282
Phone (480) 317-2141

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1992000764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W FOUNTAINHEAD PKWY",
            "address_2": "SUITE 201",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821868",
            "telephone_number": "866-475-3129",
            "fax_number": "866-687-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W FOUNTAINHEAD PKWY",
            "address_2": "SUITE 201",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821868",
            "telephone_number": "866-475-3129",
            "fax_number": "866-687-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY HEALTH SOLUTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTENE",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "866-475-3129",
        "authorized_official_credential": "VP,"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "1283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231241",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centene Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.