NPIMap

Organization Active NPI

Jones Medical Corp

Doing business as Bridgewater Medical Center

  • Primary Care Clinic/Center
  • Madisonville, KY
National Provider Identifier
1962639187
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
42115 Issued in KY
Legal business name
JONES MEDICAL CORP
Doing business as
Bridgewater Medical Center
Practice address
230 Madison Square Dr Ste C
Madisonville, KY 42431-2792
Phone
(270) 821-6262
Fax
(270) 821-6272
NPI assigned
Jun 15, 2009
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Jamie Daniel
Title
Administrator
Phone
(270) 821-6262

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 42115 KY Primary
Rural Health Clinic/Center 261QR1300X NU

Addresses

Primary practice location

230 Madison Square Dr Ste C
Madisonville, KY 42431-2792

Mailing address

230 Madison Square Dr Ste C
Madisonville, KY 42431-2792
Phone (270) 821-6262

Other names 1

  • Bridgewater Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100526000074 KY Part B Supplier - Clinic/Group Practice 5193865624 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
Practice locations: Sacramento, KY; Madisonville, KY; Owensboro, KY

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1962639187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MADISON SQUARE DR STE C",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312792",
            "telephone_number": "270-821-6262",
            "fax_number": "270-821-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MADISON SQUARE DR STE C",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312792",
            "telephone_number": "270-821-6262",
            "fax_number": "270-821-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "270-821-6262"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "42115",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgewater Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bridgewater Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.