Sandra Kalyn Ridgeway, APC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

APC006956 Issued in GA

Practice address

37 Calumet Pkwy
Newnan, GA 30263-6734

Phone

(770) 304-0072

NPI assigned

May 26, 2020

Last updated

May 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kalyn Ridgeway Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1982227864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PEBBLE WAY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652241",
            "telephone_number": "706-980-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CALUMET PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636734",
            "telephone_number": "770-304-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "SANDRA",
        "middle_name": "KALYN",
        "credential": "APC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC006956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Newnan",
            "affiliation": "N",
            "address_1": "37 Calumet Pkwy",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302636734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KALYN",
            "last_name": "RIDGEWAY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Newnan, GA
• Providers in Newnan, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.