Individual provider Active NPI

Ridwan Lingga

  • Registered Nurse
  • Lemoore, CA
National Provider Identifier
1063126027
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95245182 Issued in CA
Practice address
1169 Beverly Dr Apt 63
Lemoore, CA 93245-2494
Phone
(732) 900-8354
NPI assigned
Jan 12, 2023
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95245182 CA Primary

Addresses

Primary practice location

1169 Beverly Dr Apt 63
Lemoore, CA 93245-2494

Mailing address

1169 Beverly Dr Apt 63
Lemoore, CA 93245-2494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95245182CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1063126027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 BEVERLY DR APT 63",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932452494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 BEVERLY DR APT 63",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932452494",
            "telephone_number": "732-900-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINGGA",
        "first_name": "RIDWAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95245182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.