Active NPI
Zachary Bridges, RT(R)
- Radiologic Technologist
- Jackson, MS
National Provider Identifier
1710407192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 563727
- Practice address
- 969 Lakeland Dr
Jackson, MS 39216-4606 - Phone
- (601) 200-2000
- NPI assigned
- Jun 26, 2017
- Last updated
- Jun 26, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 563727 | MS | Primary |
Addresses
Primary practice location
969 Lakeland Dr
Jackson, MS 39216-4606
Mailing address
719 Black Oak Cir
Pearl, MS 39208-5208
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 |
|---|---|---|---|
| 563727 | MS | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498435200000",
"number": "1710407192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 BLACK OAK CIR",
"city": "PEARL",
"state": "MS",
"postal_code": "392085208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "969 LAKELAND DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164606",
"telephone_number": "601-200-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGES",
"first_name": "ZACHARY",
"credential": "RT(R)",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-26",
"last_updated": "2017-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "MS",
"license": "563727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.