Active NPI
Judith V Ridge, OPTICIAN
- Optician
- Winston-Salem, NC
National Provider Identifier
1902882236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 731
- Practice address
- 631 Coliseum Dr
Winston-Salem, NC 27106-5310 - Phone
- (336) 716-2255
- Fax
- (336) 716-7994
- NPI assigned
- Dec 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 731 | NC | Primary |
Addresses
Primary practice location
631 Coliseum Dr
Winston-Salem, NC 27106-5310
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
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
| License | State | Type | Specialty |
|---|---|---|---|
| 731 | NC | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283126400000",
"number": "1902882236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2255",
"fax_number": "336-716-7994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 COLISEUM DR",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "271065310",
"telephone_number": "336-716-2255",
"fax_number": "336-716-7994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGE",
"first_name": "JUDITH",
"middle_name": "V",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-19",
"last_updated": "2010-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston-Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.