Individual provider Active NPI

Alyx Lynnell Bridis, RN

  • Registered Nurse
  • Fairfax, VA
National Provider Identifier
1356988992
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001303331 Issued in VA
Practice address
11612 Fairfax Meadows Cir Apt 18305
Fairfax, VA 22030-8327
Phone
(703) 399-1561
NPI assigned
Dec 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Registered Nurse 163W00000X 0001303331 VA Primary

Addresses

Primary practice location

11612 Fairfax Meadows Cir Apt 18305
Fairfax, VA 22030-8327

Mailing address

11612 Fairfax Meadows Cir Apt 18305
Fairfax, VA 22030-8327
Phone (703) 399-1561

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

LicenseStateTypeSpecialty
0001303331VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1356988992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11612 FAIRFAX MEADOWS CIR APT 18305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308327",
            "telephone_number": "703-399-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11612 FAIRFAX MEADOWS CIR APT 18305",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308327",
            "telephone_number": "703-399-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDIS",
        "first_name": "ALYX",
        "middle_name": "LYNNELL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001303331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.