Individual provider Active NPI

Jason Ralph Riffle, C.P.

  • Prosthetist
  • Charlotte, NC
National Provider Identifier
1003065368
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
3707 Latrobe Dr Ste 430
Charlotte, NC 28211-1361
Phone
(704) 375-2587
Fax
(704) 333-4429
NPI assigned
Sep 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 318 TX
Prosthetist 224P00000X Primary

Addresses

Primary practice location

3707 Latrobe Dr Ste 430
Charlotte, NC 28211-1361

Mailing address

3707 Latrobe Dr Ste 430
Charlotte, NC 28211-1361
Phone (704) 375-2587

Other practice location 1

1114 Mill St
Camden, SC 29020-3712
Phone (803) 787-6911

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

LicenseStateTypeSpecialty
318TXMDProsthetics Case Management

Practice roles

OrganizationSpecialtyStatusNew patients
W.T. Hinnant Artificial Limb Co Prosthetist CurrentSince Oct 13, 2019 Accepting new patients
W.T. Hinnant Artificial Limb Co Prosthetist CurrentSince Aug 1, 2019 Accepting new patients

Locations

3707 Latrobe Dr
Ste 430
Charlotte, NC 28211
Phone (704) 375-2587

120 E Kingston Ave
Charlotte, NC 28203
Phone (704) 375-2587

1114 Mill St
Camden, SC 29020
Phone (803) 432-1147

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1003065368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 LATROBE DR STE 430",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111361",
            "telephone_number": "704-375-2587",
            "fax_number": "704-333-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 LATROBE DR STE 430",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111361",
            "telephone_number": "704-375-2587",
            "fax_number": "704-333-4429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1114 Mill St",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "SC",
            "postal_code": "290203712",
            "country_code": "US",
            "telephone_number": "803-787-6911",
            "fax_number": "704-333-4429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIFFLE",
        "first_name": "JASON",
        "middle_name": "RALPH",
        "name_prefix": "Mr.",
        "credential": "C.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "TX",
            "license": "318",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.