Active NPI
Evelyn Brooks Ridgeway, PH.D.
- Psychologist
- Philadelphia, PA
National Provider Identifier
1225541691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS008753L
- Practice address
- 4865 Market St
Philadelphia, PA 19139-3508 - Phone
- (267) 425-9941
- Fax
- (267) 425-9901
- NPI assigned
- Nov 8, 2017
- Last updated
- Nov 8, 2017
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS008753L | PA | Primary |
Addresses
Primary practice location
4865 Market St
Philadelphia, PA 19139-3508
Mailing address
Early Head Start, Karabots Pediatric Care Center
4865 Market Street
Philadelphia, PA 19139
Phone (267) 425-9941
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS008753L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510099200000",
"number": "1225541691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "EARLY HEAD START, KARABOTS PEDIATRIC CARE CENTER",
"address_2": "4865 MARKET STREET",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19139",
"telephone_number": "267-425-9941",
"fax_number": "267-425-9901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4865 MARKET ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191393508",
"telephone_number": "267-425-9941",
"fax_number": "267-425-9901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGEWAY",
"first_name": "EVELYN",
"middle_name": "BROOKS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-08",
"last_updated": "2017-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS008753L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.