BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER (NPI# 1629445846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629445846 |
| Entity Type | Organization |
| Organization Name | BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER |
| Practice Address |
75 Bay Grove Blvd Freeport FL 32439-1725 |
| Mailing Address |
Po Box 1132 Freeport FL 32439-1132 |
| Practice Telephone | 8503742311 |
| Mailing Telephone | 8503742311 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |
| Authorized Official Name | MS. LINDA IDEAN RICH (NURSE PRACTITIONER) |
| Authorized Official Telephone | 8503742311 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
2080412 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 003-331-800 | 05 |
| Street Address |
75 BAY GROVE BLVD |
| City | FREEPORT |
| State | FL |
| Zip Code | 32439-1725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518464767 | Molly Lutz | Specialist/Technologist | 12615 Business Hwy 331, Freeport, FL 32439 | 2018-04-12 |
| 1952840266 | Katherine Mclelland | Specialist/Technologist | 12615 U.S. 331 Bus, Freeport, FL 32439 | 2017-02-20 |
| 1497160360 | Jennewein, Np-c, LLC | Health Maintenance Organization | 40 Washington Street, Freeport, FL 32439 | 2014-06-30 |
| 1407292220 | Lauren Neighbors Youtz | Physician Assistant | 479 E. Hwy 20, Freeport, FL 32439 | 2013-05-20 |
| 1841537180 | Jeanne Elizabeth Brehm | Contractor | 2516 Co Hwy 3280, Freeport, FL 32439 | 2013-01-07 |
| 1417247529 | Lindsay L Shirley | Dentist | 30 Blueberry Road, Freeport, FL 32439 | 2011-04-10 |
| 1659476281 | Garlon Ray Weeks | Pharmacist | 132 East Hwy 20, Freeport, FL 32439 | 2006-09-14 |
| 1477595858 | Freeport Family Medicine LLC | Family Medicine | 1588 Highway 20 West, Freeport, FL 32439 | 2006-06-12 |
| 1366413049 | Christopher Ray Weeks | Pharmacist | 132 E Hwy 20, Freeport, FL 32439 | 2006-01-30 |
| 1992902100 | Freeport Family Chiropractic Clinic LLC | Chiropractor | 40 Washington St., Freeport, FL 32439 | 2007-06-29 |
| Find all providers in zip 32439 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972691707 | Kathleen Ann Devarso | Nurse Practitioner | 55 N Ocean Ave, Freeport, NY 11520-3035 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417072 | Carmen Moreno | Nurse Practitioner | 336 Golfview Rd Apt 909, North Palm Beach, FL 33408-3512 | 2020-11-05 |
| 1366043614 | Christi Koshy | Nurse Practitioner | 4025 N Nob Hill Rd Apt 207, Sunrise, FL 33351-5811 | 2020-11-03 |
| 1730789322 | Michelle Yen-vera | Nurse Practitioner | 18409 Nw 9th Ct, Pembroke Pines, FL 33029-3607 | 2020-11-01 |
| 1376143487 | Aimee N Jorgenson Stough | Nurse Practitioner | 91550 Overseas Hwy Ste 209, Tavernier, FL 33070-2513 | 2020-10-28 |
| 1588271233 | Olivia Janelle De Jong | Nurse Practitioner | 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 | 2020-09-28 |
| 1801407796 | Elisabeth Morley Chinlund | Nurse Practitioner | 445 Delmar Ter S Apt 5, Saint Petersburg, FL 33701-4653 | 2020-08-13 |
| 1972113025 | Nicole Horn | Nurse Practitioner | 8095 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8290 | 2020-08-04 |
| 1073131850 | Olivia Dawn Wilson | Nurse Practitioner | 5105 Clover Mist Dr, Apollo Beach, FL 33572-3417 | 2020-07-08 |
| 1427687565 | Cortney M Starr | Nurse Practitioner | 2261 Kingfisher Ln, Clearwater, FL 33762-3323 | 2020-04-01 |
| 1285263335 | Summer Leigh Moran | Nurse Practitioner | 528 W Baldwin Rd # A, Panama City, FL 32405-3313 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BRIGHT STAR PEDIATRIC AND ADOLECENT CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.