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NPI Code Detail

MEDICARE: DR. JAMES HENRY PRIDGEN M.D.

MEDICARE: DR. JAMES HENRY PRIDGEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician29495NC
2207P00000XEmergency Medicine Physician29495NC
3207Q00000XFamily Medicine Physician29495NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215083563
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES HENRY PRIDGEN M.D.
Provider Business Mailing Address
First Line : 119 HOLLY ST
Second Line :
City : HOLLY RIDGE
State : NC
Zip : 28445-7898
Country : US
Telephone Number : 910-329-1707
Fax Number : 910-329-1716
Provider Business Practice Location Address
First Line : 614 N JK POWELL BLVD
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3008
Country : US
Telephone Number : 910-640-2009
Fax Number : 910-640-3036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 02/05/2026

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