Ricardo Raul Riesco, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

044069 Issued in GA

Practice address

1933 Shields Road
Dalton, GA 30720

Phone

(706) 278-6628

Fax

(706) 278-6650

NPI assigned

Jul 25, 2006

Sex

Male

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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: drriesco@pedscare.opdirect.net

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.

• Peds Care P.C.

  • Pediatrics Physician
  • Dalton, GA
  • NPI 1679730717
  NPD (past) Authorized official
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1063435550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 SHIELDS ROAD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-278-6628",
            "fax_number": "706-278-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 SHIELDS ROAD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-278-6628",
            "fax_number": "706-278-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESCO",
        "first_name": "RICARDO",
        "middle_name": "RAUL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "044069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie N. Ricks, PA-C
• Megan Ridley Watson, IBCLC
• Adam Ellis Ridley, PA-C
• Dana Belcher Ridley, APRN, FNP-C
• Sierra Dawn Ridley, NONE-BEHAVIOR ASSIST
• Ayman M. Rifai, M.D.
• Wicky Agudelo Rigos, PT
• John Scott Riley, M.S.
• Eric Yaniel Rivera-Cruz, DC
• Robert Patterson

• Pediatrics Physician in Dalton, GA
• Providers in Dalton, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.