Phyllis M Waldridge, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

1082554 Issued in KY

Practice address

627 W 4TH St
Lexington, KY 40508-1207

Phone

(859) 253-1686

Fax

(859) 254-2743

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104966274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111217",
            "telephone_number": "859-253-1686",
            "fax_number": "859-254-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 W 4TH ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405081207",
            "telephone_number": "859-253-1686",
            "fax_number": "859-254-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRIDGE",
        "first_name": "PHYLLIS",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "KY",
            "license": "1082554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Rachel Waldman, MD
• Steven Randolph Waldman, M.D.
• Barbara Harrod Waldner, LCSW
• Justin Waldo, LCSW
• Kimberley Waldridge, RN
• Sarah Joanne Wales, MSW, CSW
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Psychiatric/Mental Health Registered Nurse in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatric/Mental Health Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.