NPIMap

Individual provider Active NPI

Jack Weldon Bridges IV, M.D.

  • Hospitalist Physician
  • Mt Pleasant, SC
National Provider Identifier
1487965935
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
38599 Issued in SC
Practice address
2000 Hospital Dr
Mt Pleasant, SC 29464
Phone
(843) 881-0100
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 38599 SC Primary

Addresses

Primary practice location

2000 Hospital Dr
Mt Pleasant, SC 29464

Mailing address

2000 Hospital Dr
Mt Pleasant, SC 29464-3764
Phone (843) 881-0100

Other practice location 1

1061 Harmon Ave
Ste 1003
Fort Stewart, GA 31314-5641
Phone (912) 435-6933

Other practice location 2

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904000694 SC Practitioner - Internal Medicine 7012152226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Group Services, LLCGroup PAC ID 1759525777, 19 clinicians

Practice addresses (Care Compare)

2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Phone (843) 881-0100

Hospital & facility affiliations

  • Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38599SCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Group Services, LLC Hospitalist CurrentSince Jul 1, 2019 Accepting new patients
East Cooper Medical Center LLC Past Accepting new patients

Locations

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1487965935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HOSPITAL DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643764",
            "telephone_number": "843-881-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HOSPITAL DR",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-881-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Harmon Ave",
            "address_2": "STE 1003",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145641",
            "country_code": "US",
            "telephone_number": "912-435-6933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "JACK",
        "middle_name": "WELDON",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "38599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.