Individual provider Active NPI

Vivian Joan Bridges, FNP-BC

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1700600970
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
37484 Issued in TN
Practice address
23 Sandstone Cir
Jackson, TN 38305-2073
Phone
(731) 265-6946
NPI assigned
Nov 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 37484 TN Primary

Addresses

Primary practice location

23 Sandstone Cir
Jackson, TN 38305-2073

Mailing address

23 Sandstone Cir
Jackson, TN 38305-2073
Phone (731) 265-6949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20241211003539 TN Practitioner - Nurse Practitioner 1557897766 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Pain Clinics IncGroup PAC ID 4183538887, 8 clinicians

Practice addresses (Care Compare)

8132 Cordova Rd
Cordova, TN 38016-6005
Phone (901) 405-6470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Pain Clinics, Inc CurrentSince Oct 1, 2024 Accepting new patients
Spectrum Pain Clinics Inc. CurrentSince Oct 1, 2024 Accepting new patients
Professional Health Services of Jackson CurrentSince Sep 2, 2025 Accepting new patients

Locations

230 E James M Campbell Blvd
Ste 102
Columbia, TN 38401
Phone (931) 840-9588

8132 Cordova Rd
Cordova, TN 38016
Phone (901) 367-0811

233 Oil Well Rd
Ste E
Jackson, TN 38305
Phone (731) 660-8467

23 Sandstone Cir
Jackson, TN 38305
Phone (731) 265-6946

Organizations & group practices 6

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": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1700600970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SANDSTONE CIR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052073",
            "telephone_number": "731-265-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SANDSTONE CIR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052073",
            "telephone_number": "731-265-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "VIVIAN",
        "middle_name": "JOAN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "37484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.