JERRY ALAN BRIDGHAM MD
NPI 1740361336
Pediatrics - Adolescent Medicine in Jacksonville, FL

Active since October 18, 2006
14810 OLD SAINT AUGUSTINE RD STE 106, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32258(904) 268-7701(904) 268-9708 Get Directions Write a Review

NPPES record last updated: November 19, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jerry Alan Bridgham Md NPPES

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

JERRY ALAN BRIDGHAM MD (NPI 1740361336) is an individual adolescent medicine provider in Jacksonville, Florida, licensed in Florida (ME49397) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1740361336
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameJERRY ALAN BRIDGHAMCredential: MD
Location Address14810 OLD SAINT AUGUSTINE RD STE 106, CREDENTIALING DEPARTMENTJacksonville, FL 32258-2558
Mailing AddressPo Box 44004Jacksonville, FL 32231-4004 · (904) 202-1032 · Fax (904) 268-9708
Fax(904) 268-9708
Sole ProprietorNo
Enumeration DateOctober 18, 2006
Last NPPES UpdateNovember 19, 2015
NPI 1740361336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License Licensed in FL · ME49397
Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

14810 OLD SAINT AUGUSTINE RD STE 106, Jacksonville, FL 32258

Other Identifiers 2

Medicaid3747107-00FL
Medicare UPINE60463

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
14810 OLD SAINT AUGUSTINE RD STE 106
JACKSONVILLE, FL 32258
Nurse Practitioner
14810 OLD SAINT AUGUSTINE RD STE 106
JACKSONVILLE, FL 32258
Pediatrics
14810 OLD SAINT AUGUSTINE RD STE 106
JACKSONVILLE, FL 32258
Pediatrics
14810 OLD SAINT AUGUSTINE RD STE 106, CREDENTIALING DEPARTMENT
JACKSONVILLE, FL 32258

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 Jerry Bridgham's NPI number?

The NPI number for Jerry Bridgham is 1740361336. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Jerry Bridgham located?

Jerry Bridgham practices at 14810 Old Saint Augustine Rd Ste 106 Credentialing Department, Jacksonville, FL 32258. The listed phone number is (904) 268-7701.

What is Jerry Bridgham's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

When was this NPI record last updated?

The NPPES record for Jerry Bridgham was last updated on November 19, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.