Stanley Lee Ridner III

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

23528 Issued in TN

Practice address

365 Stout Drive
Suite 160
Johnson City, TN 37614

Phone

(423) 439-4225

Fax

(423) 439-4560

NPI assigned

Jan 30, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1083750590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E BROADWAY",
            "address_2": "290",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021785",
            "telephone_number": "502-217-5134",
            "fax_number": "502-217-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 STOUT DRIVE",
            "address_2": "SUITE 160",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37614",
            "telephone_number": "423-439-4225",
            "fax_number": "423-439-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDNER",
        "first_name": "STANLEY",
        "middle_name": "LEE",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "23528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "23528",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Alora Ricker
• Stephanie Grindstaff Ricker, BS
• Karly Riddle, PHARMD
• Mikala Riddlesworth, PHYSICIAN ASSISTANT
• Daniel Earl Ridlen, MD
• Kristen Fowler Riem, PHD
• Diana H Riffe, CRNA
• Kristin Bounds Righi, PA-C
• Right Coast Medical, LLC
• Christine M. Rigsby, APN

• Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.