Bridge Clinic, PLLC
NPI 1194561670ActiveOrganization· Dermatology· St George, UT
Dermatology in St George, Utah, registered in NPPES in July 2024. The authorized official on file is Trent Kenworthy, NP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1194561670 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 3, 2024 |
| Last updated in NPPES | Sep 10, 2024 |
| Certified by provider | Sep 10, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
| Clinic/Center, Multi-Specialty | 261QM1300X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
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