Active NPI
Charles Bridges IV
- Health Educator
- Niceville, FL
National Provider Identifier
1093137143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- W019590
- Practice address
- 111 Midland CT
Niceville, FL 32578-9765 - Phone
- (850) 499-2930
- NPI assigned
- Jan 8, 2014
- Last updated
- Jan 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | W019590 | FL | Primary |
Addresses
Primary practice location
111 Midland CT
Niceville, FL 32578-9765
Mailing address
111 Midland CT
Niceville, FL 32578-9765
Phone (850) 499-2930
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W019590 | FL | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1093137143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MIDLAND CT",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325789765",
"telephone_number": "850-499-2930",
"fax_number": "850-897-0372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MIDLAND CT",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325789765",
"telephone_number": "850-499-2930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGES",
"first_name": "CHARLES",
"name_suffix": "IV",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-08",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "FL",
"license": "W019590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.