Individual provider Active NPI

Victoria Marlee Ridgeway, FNP-C

  • Family Nurse Practitioner
  • Florence, AL
National Provider Identifier
1376258301
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3-001162 Issued in AL
Practice address
1949 Florence Blvd
Florence, AL 35630-2729
Phone
(256) 415-8100
NPI assigned
Jan 13, 2023
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3-001162 AL Primary
Registered Nurse 163W00000X 917007 MS

Addresses

Primary practice location

1949 Florence Blvd
Florence, AL 35630-2729

Mailing address

509 W 5TH St
Iuka, MS 38852-1602
Phone (662) 660-6085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20240515000497 AL Practitioner - Nurse Practitioner 6204277759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Center of Northwest Alabama, LLCGroup PAC ID 1850621418, 4 clinicians

Practice addresses (Care Compare)

1949 Florence Blvd
Florence, AL 35630-2729
Phone (417) 986-6734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
917007MSMDRegistered Nurse
3-001162ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Center of Northwest Alabama, LLC CurrentSince Mar 30, 2024 Accepting new patients
Southern Anesthesia Consultants LLC PastSince Jul 1, 2025 Accepting new patients

Locations

1949 Florence Blvd
Florence, AL 35630
Phone (256) 415-8100

210 Seville St
Florence, AL 35630
Phone (256) 415-8100

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1376258301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W 5TH ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521602",
            "telephone_number": "662-660-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 FLORENCE BLVD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356302729",
            "telephone_number": "256-415-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "VICTORIA",
        "middle_name": "MARLEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-001162",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "917007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.