Individual provider Active NPI

Ronda Katrice Bridgeman

  • In Home Supportive Care Agency
  • Jacksonville, FL
National Provider Identifier
1043899628
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
12348 Dewhurst Cir
Jacksonville, FL 32218-9608
Phone
(904) 405-4911
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

12348 Dewhurst Cir
Jacksonville, FL 32218-9608

Mailing address

12348 Dewhurst Cir
Jacksonville, FL 32218-9608
Phone (904) 405-4911

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Jacksonville

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1043899628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12348 DEWHURST CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322189608",
            "telephone_number": "904-405-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12348 DEWHURST CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322189608",
            "telephone_number": "904-405-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGEMAN",
        "first_name": "RONDA",
        "middle_name": "KATRICE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jacksonville",
            "affiliation": "N",
            "endpointDescription": "Office",
            "address_1": "12348 Dewhurst Cir",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322189608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.