TYLER ASHTON BRIDGEWATER (FNP-C) – Family Nurse Practitioner, NPI 1215378377

TYLER ASHTON BRIDGEWATER (FNP-C) is a healthcare provider. based in North salt lake, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 7078841-4405 (UT). The NPI Number for TYLER ASHTON BRIDGEWATER (FNP-C) is 1215378377

Main info

Male
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
TYLER ASHTON BRIDGEWATER (FNP-C)
NPI
1215378377
Phone
(801) 244-8968
Address
976 FOXBORO DR
Enumeration Date
17 July 2013
Last Update Date
17 July 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8599482390
Graduation Year
2013 (13 years ago)
PAC ID
6406148444
Group Practice PAC ID
3476954793
Professional Enrollment ID
I20240717001650
Address ID
UT840484157LE3401XWAYX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

2,657 NURSE PRACTITIONER in UT

Provider Addresses for TYLER ASHTON BRIDGEWATER (FNP-C)

  • 976 FOXBORO DR

    NORTH SALT LAKE, UT 840546002

    Phone: (801) 244-8968

    Type: Mailing

  • 401 S 400 E

    BOUNTIFUL, UT 840104933

    Phone: (801) 295-2361

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-10-24 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240717001650INurse PractitionerUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84054)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476954793View full group profile
NameSpecialtyState
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
P O D I A T R YUT
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
P O D I A T R YNY
Nurse PractitionerUT
P O D I A T R YMO

Reviews

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Frequently asked questions

How is TYLER ASHTON BRIDGEWATER (FNP-C) identified in CMS data?
CMS-hosted NPPES data lists TYLER ASHTON BRIDGEWATER (FNP-C) with NPI 1215378377.
Is TYLER ASHTON BRIDGEWATER (FNP-C) still practicing?
TYLER ASHTON BRIDGEWATER (FNP-C) is currently listed as active in the public NPI registry.
What taxonomy line describes TYLER ASHTON BRIDGEWATER (FNP-C)?
For research purposes, treat TYLER ASHTON BRIDGEWATER (FNP-C) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is TYLER ASHTON BRIDGEWATER (FNP-C) based?
TYLER ASHTON BRIDGEWATER (FNP-C) is tied to North Salt Lake, Utah in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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