Individual provider Active NPI

Ashley S. Brigdon, FNP

  • Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1174990956
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN191988 Issued in GA
Practice address
4700 Waters Ave 1St Floor Mus BLDG
Savannah, GA 31404
Phone
(912) 350-3438
Fax
(912) 350-9037
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN191988 GA
Nurse Practitioner 363L00000X RN191988 GA Primary

Addresses

Primary practice location

4700 Waters Ave 1St Floor Mus BLDG
Savannah, GA 31404

Mailing address

4700 Waters Ave 1St Floor Mus BLDG
Savannah, GA 31404-6220
Phone (912) 350-3438

Other practice location 1

4700 Waters Ave
1St Floor Mus BLDG
Savannah, GA 31404-6220
Phone (912) 350-3438

Other identifiers 1

IdentifierTypeStateIssuer
003171022AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160106001128 GA Practitioner - Nurse Practitioner 7517269681 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN191988GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MPPG, Inc. CurrentSince Nov 23, 2015 Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

4731 Waters Ave
Savannah, GA 31404
Phone (912) 350-4905

4700 Waters Ave
Fl 1
Savannah, GA 31404
Phone (912) 350-3438

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1174990956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE 1ST FLOOR MUS BLDG",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-3438",
            "fax_number": "912-350-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE 1ST FLOOR MUS BLDG",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31404",
            "telephone_number": "912-350-3438",
            "fax_number": "912-350-9037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_2": "1ST FLOOR MUS BLDG",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-3438",
            "fax_number": "912-350-9037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIGDON",
        "first_name": "ASHLEY",
        "middle_name": "S.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN191988",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN191988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003171022A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.