Karlene Ridgeway, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2022045904 Issued in MO

Practice address

2701 Covey LN
Jefferson City, MO 65109-9214

Phone

(573) 291-1767

NPI assigned

Apr 5, 2024

Last updated

Apr 5, 2024By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1770335226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 COVEY LN",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099214",
            "telephone_number": "573-291-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 COVEY LN",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099214",
            "telephone_number": "573-291-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "KARLENE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2022045904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.