Active NPI
Jerome Patridge, DO
- Anesthesiology Physician
- Tempe, AZ
National Provider Identifier
1992711535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2031
- Practice address
- 2000 E Southern Ave Ste 102
Tempe, AZ 85282-7510 - Phone
- (480) 820-9141
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2031 | AZ | Primary |
Addresses
Primary practice location
2000 E Southern Ave Ste 102
Tempe, AZ 85282-7510
Mailing address
2000 E Southern Ave Ste 102
Tempe, AZ 85282-7510
Phone (480) 820-9141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 239138 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Verde Valley Medical Center | 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.
-
- General Acute Care Hospital
- Cottonwood, AZ
- NPI 1346291648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543363200000",
"number": "1992711535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 E SOUTHERN AVE STE 102",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852827510",
"telephone_number": "480-820-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 E SOUTHERN AVE STE 102",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852827510",
"telephone_number": "480-820-9141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRIDGE",
"first_name": "JEROME",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2018-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AZ",
"license": "2031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "239138",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.