BRIDGES MEDICAL GROUP LLC (NPI# 1427693852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427693852 |
| Entity Type | Organization |
| Organization Name | BRIDGES MEDICAL GROUP LLC |
| Practice Address |
140 Bridges Rd Ste E Mauldin SC 29662-3260 |
| Mailing Address |
2250 E Germann Rd Ste 8 Chandler AZ 85286-1575 |
| Practice Telephone | 4809267800 |
| Mailing Telephone | 4809267800 |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | MINOO RAHIMI (CFO) |
| Authorized Official Telephone | 4809267800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
Chiropractic Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
140 BRIDGES RD STE E |
| City | MAULDIN |
| State | SC |
| Zip Code | 29662-3260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134623861 | Superior Healthcare Physical Medicine of Mauldin | Physical Medicine & Rehabilitation | 140 Bridges Rd Ste E, Mauldin, SC 29662-3260 | 2018-03-19 |
| 1861037202 | Conestee Medical Group LLC | Chiropractor | 140 Bridges Rd Ste E, Mauldin, SC 29662-3260 | 2019-11-08 |
| 1689219024 | Discovery Medical Group LLC | Chiropractor | 140 Bridges Rd Ste E, Mauldin, SC 29662-3260 | 2019-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154862399 | Connie Painter | Behavior Technician | 103 Miller Rd, Mauldin, SC 29662 | 2017-03-20 |
| 1073061610 | Lisa Rist | Counselor | 400 South Main St Suite C, Mauldin, SC 29662 | 2016-09-12 |
| 1285181347 | Jennifer Wise | Specialist/Technologist | 310 Neely Ferry Road, Mauldin, SC 29662 | 2016-09-07 |
| 1467908236 | Maan Aziz Kerzzo | Pharmacist | 129 West Butler Road, Mauldin, SC 29662 | 2016-08-31 |
| 1083011357 | Southeast Transportation Services LLC | Non-emergency Medical Transport (VAN) | 411 N. Main St., Mauldin, SC 29662 | 2014-12-02 |
| 1174926471 | Holly Christine Waite | Chiropractor | 785 E Butler Rd, Ste D, Mauldin, SC 29662 | 2014-09-30 |
| 1194138701 | Vanessa Vance-logan | Case Manager/Care Coordinator | 400 West Butler Road; Suite B-1, Mauldin, SC 29662 | 2014-06-11 |
| 1265771984 | Connie Mae Lenagh | Nurse Practitioner | 924 E. Butler Rd, Mauldin, SC 29662 | 2013-02-01 |
| 1679823918 | Linda W Gerhart | Pharmacist | 224 East Butler Rd, Mauldin, SC 29662 | 2012-09-13 |
| 1114277894 | David Merz Banks | Pharmacist | 315 West Butler Rd, Mauldin, SC 29662 | 2012-09-11 |
| Find all providers in zip 29662 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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| 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.