Mary Jean Ridges, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2661863501 Issued in UT

Practice address

750 N Freedom Blvd
Provo, UT 84601-1677

Phone

(801) 373-4760

Fax

(801) 373-0639

NPI assigned

Aug 20, 2019

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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wasatch Behavioral Health Special Service DistrictGroup PAC ID 2567367915, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115
  Medicare reassignment Care Compare group NPD
• Wasatch Behavioral Health Special Service District

  • Clinical Medical Laboratory
  • Orem, UT
  • NPI 1669257556
  NPD

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1053968529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 E 600 S",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846064806",
            "country_code": "US",
            "telephone_number": "801-367-5710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDGES",
        "first_name": "MARY JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "2661863501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A. Richey, MD
• Christopher Ricks, MD
• Leslie Riddle
• Seth Allred Riddle, M.D.
• Aaron Foster Ridenour
• Teri J Riding, ATC
• Mackenzie Ridley, PA
• James Rielly
• Brennan Dwight Rigby, MD
• Jennifer Brimhall Rigby, APRN

• Clinical Social Worker in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.