Bridgewell LLC
NPI 1972296382ActiveOrganization· Nurse Practitioner, Primary Care· Bolingbrook, IL
Nurse Practitioner, Primary Care in Bolingbrook, Illinois, registered in NPPES in May 2023. The authorized official on file is Isoken Ogbomo, FNP, Nurse Practitioner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1972296382 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 31, 2023 |
| Last updated in NPPES | Sep 1, 2023 |
| Certified by provider | Sep 1, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
| Clinic/Center, Community Health | 261QC1500X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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