Jordan Emile Vidrine, SRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN156033 Issued in LA

Practice address

3330 Masonic Dr
Alexandria, LA 71301-3841

Phone

(318) 487-1122

NPI assigned

Jul 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mid-Louisiana Anesthesia Consultants, Apmc

  • Anesthesiology Physician
  • Alexandria, LA
  • NPI 1205888914
  Medicare reassignment NPD

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

{
    "created_epoch": "1721433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1750129953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 TIMMY ST",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705867509",
            "telephone_number": "337-230-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013841",
            "telephone_number": "318-487-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "JORDAN",
        "middle_name": "EMILE",
        "credential": "SRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-20",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN156033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Vermaelen, O.T.
• Versailles Healthcare LLC
• Victor J Caronna DDS LLC
• Anna Lynn Vidrine
• Jill Vidrine, NP
• Shelby Helmer Vidrine, APRN-CNP
• Edward Ray Villemez II, M.D.
• Vincent D. Mallory MD., LLC
• Beckie Leigh Vincent
• Delandria Vincent

• Registered Nurse in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.