Individual provider Active NPI

Riley Andridge, DNP

  • Certified Registered Nurse Anesthetist
  • Marquette, MI
National Provider Identifier
1811639610
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704388656 Issued in MI
Practice address
850 W Baraga Ave
Marquette, MI 49855-4550
Phone
(906) 449-3000
NPI assigned
Apr 12, 2022
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704388656 MI Primary

Addresses

Primary practice location

850 W Baraga Ave
Marquette, MI 49855-4550

Mailing address

710 Chippewa SQ
Marquette, MI 49855-4821

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220723000270 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779964648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology of Marquette, P.C.Group PAC ID 6103851712, 26 clinicians

Practice addresses (Care Compare)

850 W Baraga Ave
Marquette, MI 49855-4550
Phone 9062262569100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704388656MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology of Marquette, P.C. CurrentSince Jun 15, 2022 Accepting new patients

Locations

710 Chippewa Sq
Marquette, MI 49855
Phone (906) 226-2569

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

Organizations & group practices 1

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": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1811639610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CHIPPEWA SQ",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRIDGE",
        "first_name": "RILEY",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704388656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.