Wesley Evan Ridgdill, R.N.

Key facts

NPI

1134413115

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

RN-140945 (CO)

Practice address

456 Brookside Dr
Bailey, CO 80421-2103

Phone

(303) 548-0319

NPI assigned

Jun 7, 2011

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134413115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 BROOKSIDE DR",
            "city": "BAILEY",
            "state": "CO",
            "postal_code": "804212103",
            "telephone_number": "303-548-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 BROOKSIDE DR",
            "city": "BAILEY",
            "state": "CO",
            "postal_code": "804212103",
            "telephone_number": "303-548-0319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Van Gordon St",
            "address_2": "Unit 16-187",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281512",
            "country_code": "US",
            "telephone_number": "303-548-0319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDGDILL",
        "first_name": "WESLEY",
        "middle_name": "EVAN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN-140945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Bailey, CO · Registered Nurse in Colorado