Individual provider Active NPI

Renee L Bridges, FNP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1053884247
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21968 Issued in SC
Practice address
117 Commons Way
Greenville, SC 29611-3850
Phone
(864) 970-2273
NPI assigned
Jan 10, 2019
Last updated
Nov 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21968 SC Primary

Addresses

Primary practice location

117 Commons Way
Greenville, SC 29611-3850

Mailing address

191 Redcroft Dr
Greer, SC 29651-7004

Other practice location 1

10 Enterprise Blvd Ste 202
Greenville, SC 29615-3554
Phone (864) 608-8847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190402002114 SC Practitioner - Nurse Practitioner 5294076105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Itrust Cares LLCGroup PAC ID 5092189712, 8 clinicians

Practice addresses (Care Compare)

127 Commons Way
Greenville, SC 29611-3850
Phone (864) 970-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21968SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Itrust Wellness Group Therapeutics CurrentSince Nov 6, 2022 Accepting new patients
Itrust Cares LLC CurrentSince Mar 22, 2023 Accepting new patients

Locations

117 Commons Way
Greenville, SC 29611
Phone (303) 667-6742

127 Commons Way
Greenville, SC 29611
Phone (864) 416-4560

149 Commons Way
Greenville, SC 29611

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1053884247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 REDCROFT DR",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296517004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 COMMONS WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113850",
            "telephone_number": "864-970-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Enterprise Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296153554",
            "country_code": "US",
            "telephone_number": "864-608-8847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "RENEE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.