Individual provider Active NPI

Demetris Dewayne Aldridge

  • Emergency Registered Nurse
  • Virginia Beach, VA
National Provider Identifier
1730940271
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
9533725 Issued in FL
Practice address
1881 University Dr
Virginia Beach, VA 23453-8083
Phone
(757) 775-6694
NPI assigned
Jan 22, 2024
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 9533725 FL Primary

Addresses

Primary practice location

1881 University Dr
Virginia Beach, VA 23453-8083

Mailing address

1881 University Dr
Virginia Beach, VA 23453-8083
Phone (757) 775-6694

Other practice location 1

1881 University Dr
Virginia Beach, VA 23453-8083
Phone (757) 775-6694

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

State licenses

LicenseStateTypeSpecialty
9533725FLMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1730940271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 UNIVERSITY DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234538083",
            "telephone_number": "757-775-6694"
        },
        {
            "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": "234538083",
            "telephone_number": "757-775-6694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1881 University Dr",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234538083",
            "country_code": "US",
            "telephone_number": "757-775-6694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALDRIDGE",
        "first_name": "DEMETRIS",
        "middle_name": "DEWAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "9533725",
            "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 Jan 22, 2024; 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.