JERRY A. BRIDGHAM MD – NPI #1740361336
Pediatrics

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

JERRY BRIDGHAM is a physician located in JACKSONVILLE, FL. NPPES has assigned the NPI number 1740361336 to JERRY BRIDGHAM on October 18, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2080A0000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Adolescent Medicine

The NPI profile was previously updated about 11 years ago on Nov 19, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JERRY BRIDGHAM below.

NPI Profile for
JERRY A. BRIDGHAM

NPI Number
1740361336
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JERRY A. BRIDGHAM
Credentials
MD
Primary location
14810 OLD SAINT AUGUSTINE RD STE 106
CREDENTIALING DEPARTMENT
JACKSONVILLE, FL 32258-2558
Phone: (904) 268-7701 Fax: (904) 268-9708
Mailing address
PO BOX 44004
JACKSONVILLE, FL 32231-4004
Phone: (904) 202-1032 Fax: (904) 268-9708
Sole Proprietor
No
Updated
Identifiers

Identifiers for JERRY BRIDGHAM

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDFL3747107-00
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080A0000X
- Pediatrics / Adolescent Medicine (Primary)
FL ME49397

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.