Individual provider Active NPI

Mary Louise Wooldridge, MSN, APRN, BC

  • Family Nurse Practitioner
  • Lackland Air Force Base, TX
National Provider Identifier
1215900170
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Practice address
433 Aerospace Medicine Squadron
203 Galaxy Rd Suite 106
Lackland Air Force Base, TX 78236-0112
Phone
(210) 925-5341
NPI assigned
Feb 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TX Primary

Addresses

Primary practice location

433 Aerospace Medicine Squadron
203 Galaxy Rd Suite 106
Lackland Air Force Base, TX 78236-0112

Mailing address

Wilford Hall Medical Center Attn: Credentials (CMC)
2200 Bergquist Drive Suite 1
Lackland AFB, TX 78236-5300
Phone (210) 925-5341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0284815-22TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215900170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WILFORD HALL MEDICAL CENTER ATTN: CREDENTIALS (CMC)",
            "address_2": "2200 BERGQUIST DRIVE SUITE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365300",
            "telephone_number": "210-925-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 AEROSPACE MEDICINE SQUADRON",
            "address_2": "203 GALAXY RD SUITE 106",
            "city": "LACKLAND AIR FORCE BASE",
            "state": "TX",
            "postal_code": "782360112",
            "telephone_number": "210-925-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLDRIDGE",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland Air Force Base, TX

Sources for this page

Verify at the official NPI Registry.