ST. GEORGE DERMATOLOGY
NPI 1194561670
Dermatology in St George, UT

Active since July 03, 2024
230 N 1680 E STE N1, ST GEORGE, UT 84790(435) 313-7237 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 10, 2024, Aug 23, 2024, Jul 3, 2024 (3 updates tracked since 2024).

About St. George Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST. GEORGE DERMATOLOGY (NPI 1194561670) is a healthcare organization registered as a dermatology in St George, Utah and active in the NPI registry since July 2024. The organization lists Trent Kenworthy, Owner, as its authorized official.

NPPES Registry Identity

NPI1194561670
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBRIDGE CLINIC, PLLC
Location Address230 N 1680 E STE N1St George, UT 84790-2596
Mailing Address230 N 1680 E Ste N1St George, UT 84790-2596 · (435) 313-7237
Organization SubpartNo
Authorized OfficialTrent KenworthyOwner · (435) 313-7237
Enumeration DateJuly 3, 2024
Last NPPES UpdateSeptember 10, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2024
✔ NPI 1194561670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
230 N 1680 E STE N1, St George, UT 84790

Other Names 1

Doing Business AsSt. George Dermatology

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St. George Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to St. George Dermatology, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Dermatology
NPI 1750767638
230 N 1680 E STE N1
St George, UT 84790
(435) 680-3376
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1407321722
230 N 1680 E STE N
St George, UT 84790
(435) 680-3376
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bridge Clinic, PLLC's NPI number?

The NPI number for Bridge Clinic, PLLC is 1194561670. It was assigned to this organization in the NPPES registry on July 3, 2024. The provider is doing business as St. George Dermatology.

Where is Bridge Clinic, PLLC located?

Bridge Clinic, PLLC is located at 230 N 1680 E Ste N1, St George, UT 84790. The listed phone number is (435) 313-7237.

What is Bridge Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Bridge Clinic, PLLC enrolled in Medicare?

Yes. Bridge Clinic, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bridge Clinic, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Bridge Clinic, PLLC, in Dermatology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bridge Clinic, PLLC was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.