Jeffrey Lee Ridout

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

3393 E Morenci Rd
San Tan Valley, AZ 85143-5979

Phone

(480) 415-9949

NPI assigned

Apr 6, 2019

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554508800000",
    "number": "1073076113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 E MORENCI RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435979",
            "telephone_number": "480-415-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 E MORENCI RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435979",
            "telephone_number": "480-415-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDOUT",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-06",
        "last_updated": "2019-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ricci, FNP-BC
• Richlin Regal Residency
• Richlin Regal Residency
• Riley Nicole Herman Ricks, PA-C
• Tara Michelle Ridgeway, APRN
• Rising Star Behavior Health LLC
• Jim W Roarty, P.T.
• A'Lisa Roberts
• Courtney Rockhill
• Adriane Rene Rohrer, AGACNP

• Surgical Assistant in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Surgical Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; 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.