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EVAN LEWIS RIDENOUR
NPI 1477164143
Military Health Care Provider - Independent Duty Corpsman in Virginia Beach, VA

Active since August 14, 2020
472 POLARIS ST BLDG 586, VIRGINIA BEACH, VA 23461(757) 862-2745 Get Directions Write a Review

NPPES record last updated: June 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 8, 2023, Aug 14, 2020 (2 updates tracked since 2020).

About Evan Lewis Ridenour NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN LEWIS RIDENOUR (NPI 1477164143) is an individual independent duty corpsman provider in Virginia Beach, Virginia and active in the NPI registry since August 2020.

NPPES Registry Identity

NPI1477164143
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameEVAN LEWIS RIDENOUR
Location Address472 POLARIS ST BLDG 586Virginia Beach, VA 23461-1935
Mailing Address472 Polaris St Bldg 586Virginia Beach, VA 23461-1935 · (757) 862-2745
Phone(757) 862-2745
Sole ProprietorNo
Enumeration DateAugust 14, 2020
Last NPPES UpdateJune 8, 20232 updates tracked since enumeration
NPPES CertifiedJune 8, 2023
✔ NPI 1477164143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
472 POLARIS ST BLDG 586, Virginia Beach, VA 23461
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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA KATHLEEN CARGILL PA-C
Physician Assistant (Medical)
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (757) 862-0065
OWEN WILHELM HORTON IDC
Military Health Care Provider (Independent Duty Corpsman)
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (503) 862-0060
MR. STEVEN BRIAN BENNETT PA-C
Physician Assistant (Medical)
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (757) 862-0079
VIRGINIA MASSEY PROFESSIONAL COUNSEL
Counselor (Professional)
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (757) 862-0070
MATTHEW JAMES COOL
Military Health Care Provider
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (757) 862-0060
MATTHEW DEFRIES L02A
Military Health Care Provider (Independent Duty Corpsman)
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (219) 869-1039
MR. STEPHEN RUSSELL BROOKS NAVY IDC
Technician
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (910) 741-9612
MATTHEW E GAFFIGAN MD
Emergency Medicine
472 POLARIS ST BLDG 586
VIRGINIA BEACH, VA 23461
Virginia Beach City (757) 862-0061

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evan Ridenour's NPI number?

The NPI number for Evan Ridenour is 1477164143. It was assigned to this individual provider in the NPPES registry on August 14, 2020.

Where is Evan Ridenour located?

Evan Ridenour practices at 472 Polaris St Bldg 586, Virginia Beach, VA 23461. The listed phone number is (757) 862-2745.

What is Evan Ridenour's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Evan Ridenour was last updated on June 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.