Evangeline Mahima Standridge

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11009632 Issued in FL

Practice address

2021 Park Ave W
Ontario, OH 44906-2259

Phone

(567) 560-5558

NPI assigned

Oct 13, 2020

Last updated

Dec 9, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Simpson Chiropractic, LLC

  • Rehabilitation Chiropractor
  • Mansfield, OH
  • NPI 1629303078
  NPD (past)
• Whiteamire Clinic PA Inc

  • Chiropractor
  • Ontario, OH
  • NPI 1619168614
  NPD (past)

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1174121156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 EVERGREEN AVE W",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449052205",
            "telephone_number": "469-314-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062259",
            "telephone_number": "567-560-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDRIDGE",
        "first_name": "EVANGELINE",
        "middle_name": "MAHIMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11009632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Spellman
• Meredith Rose Spoon, OTR/L
• Megan Square
• Roopa S. Srikantiah-Saha, MD
• Brooke Stamper, NP-C
• Daci Statler, MS, BCBA, COBA
• Hannah Steigerwalt, PTA
• Beth A. Steinmetz, AGPCNP-BC
• Kila Stillion
• Kelvin Frank Stimpert, MD

• Family Nurse Practitioner in Ontario, OH
• Providers in Ontario, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.