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NPI Code Detail

MEDICARE: CAREBRIDGE MEDICAL GROUP NJ PC

MEDICARE: CAREBRIDGE MEDICAL GROUP NJ PC
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
1207Q00000XFamily Medicine Physician
2363L00000XNurse Practitioner
3207R00000XInternal Medicine Physician

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 : 1386412203
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAREBRIDGE MEDICAL GROUP NJ PC
Provider Business Mailing Address
First Line : 510 GREAT CIRCLE RD
Second Line : FL 3
City : NASHVILLE
State : TN
Zip : 37228
Country : US
Telephone Number : 615-585-1181
Fax Number : 615-235-9725
Provider Business Practice Location Address
First Line : 101 HUDSON ST FL 21
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07302-3929
Country : US
Telephone Number : 615-436-9060
Fax Number :
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. MELINDA S HENDERSON
Credential : MD
Telephone Number : 615-436-9060
Provider Enumeration Date : 12/20/2023
Last Update Date : 05/14/2026

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