Organization Active NPI

Bridgeway Diagnostic Radiology

  • Diagnostic Radiology Physician
  • Phenix City, AL
National Provider Identifier
1306248729
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BRIDGEWAY DIAGNOSTIC RADIOLOGY
Practice address
5007 Summerville Road
Phenix City, AL 36867-1559
Phone
(334) 408-2854
Fax
(334) 384-9274
NPI assigned
Sep 17, 2014
Last updated
Jul 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Dr. Jason Hoover, M.D.NPI 1225215486
Title
M.D./Owner
Phone
(334) 408-2854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X AL Primary

Addresses

Primary practice location

5007 Summerville Road
Phenix City, AL 36867-1559

Mailing address

PO Box 242848
Montgomery, AL 36124-2848
Phone (334) 386-9357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA, CA, SC, FL, IL, PA, TX8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20150108001370 AL Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 17 practitioners
Practice locations: Auburn, AL; Phenix City, AL
O20190604001681 GA Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 7 practitioners
Practice locations: Columbus, GA
O20230720003099 CA Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 2 practitioners
Practice locations: Glendale, CA; Newport Beach, CA
O20230731001098 SC Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 1 practitioner
Practice locations: Blythewood, SC
O20230802000030 FL Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 4 practitioners
Practice locations: Jacksonville, FL; Melbourne, FL; Orlando, FL; Weston, FL; Delray Beach, FL
O20230824003549 IL Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Zurich, IL
O20230831000132 PA Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 1 practitioner
Practice locations: Presto, PA
O20230921000880 TX Part B Supplier - Clinic/Group Practice 8224351788 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2086760Bridgeway Diagnostic Radiology, LLC5007 Summerville Road, Phenix City, AL 36867Certificate of waiverNov 11, 2026

National Provider Directory

National Provider Directory

Locations

5007 Summerville Rd
Phenix City, AL 36867
Phone (334) 323-3937

100 Bascom Ct
Columbus, GA 31909
Phone (706) 350-5800

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1306248729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242848",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361242848",
            "telephone_number": "334-386-9357",
            "fax_number": "334-532-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5007 SUMMERVILLE ROAD",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368671559",
            "telephone_number": "334-408-2854",
            "fax_number": "334-384-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY DIAGNOSTIC RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "334-408-2854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.