Active NPI
Victor G Bridges, PAC
- Surgical Physician Assistant
- Knoxville, TN
National Provider Identifier
1760475891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 014
- Practice address
- 939 Emerald Ave
Suite 905
Knoxville, TN 37917-4502 - Phone
- (865) 647-3350
- Fax
- (865) 647-3359
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 014 | TN | Primary |
Addresses
Primary practice location
939 Emerald Ave
Suite 905
Knoxville, TN 37917-4502
Mailing address
939 Emerald Ave
Suite 905
Knoxville, TN 37917-4502
Phone (865) 647-3350
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014 | TN | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395619200000",
"number": "1760475891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "939 EMERALD AVE",
"address_2": "SUITE 905",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379174502",
"telephone_number": "865-647-3350",
"fax_number": "865-647-3359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 EMERALD AVE",
"address_2": "SUITE 905",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379174502",
"telephone_number": "865-647-3350",
"fax_number": "865-647-3359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGES",
"first_name": "VICTOR",
"middle_name": "G",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2014-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TN",
"license": "014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.