Individual provider Active NPI

Mallory Jean Wooldridge

  • Neonatal Intensive Care Registered Nurse
  • Virginia Beach, VA
National Provider Identifier
1417863929
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X
License
RN69921 Issued in NV
Practice address
1881 University Dr
Virginia Beach, VA 23453-8001
Phone
(757) 683-4297
Fax
(757) 683-5253
NPI assigned
Aug 24, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X RN69921 NV Primary

Addresses

Primary practice location

1881 University Dr
Virginia Beach, VA 23453-8001

Mailing address

8148 Little Skye CT
Las Vegas, NV 89166-6590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1417863929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8148 LITTLE SKYE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891666590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 UNIVERSITY DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234538001",
            "telephone_number": "757-683-4297",
            "fax_number": "757-683-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLDRIDGE",
        "first_name": "MALLORY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "NV",
            "license": "RN69921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.