Active NPI
DJ Southpaw Wooldridge, RN
- Registered Nurse
- Santa Fe, NM
National Provider Identifier
1194467159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN67406
- Practice address
- 1060 Cerrillos Rd
Santa Fe, NM 87505-1650 - Phone
- (505) 216-2034
- NPI assigned
- Apr 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN67406 | NM | Primary |
Addresses
Primary practice location
1060 Cerrillos Rd
Santa Fe, NM 87505-1650
Mailing address
PO Box 35172
Albuquerque, NM 87176-5172
Phone (775) 200-9892
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN67406 | NM | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649635200000",
"number": "1194467159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35172",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871765172",
"telephone_number": "775-200-9892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 CERRILLOS RD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875051650",
"telephone_number": "505-216-2034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLDRIDGE",
"first_name": "DJ",
"middle_name": "SOUTHPAW",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-11",
"last_updated": "2022-04-11",
"certification_date": "2022-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "RN67406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.