NPIMap

Individual provider Active NPI

Wendy Ann Ridenour, PA-C

  • Physician Assistant
  • Chandler, AZ
National Provider Identifier
1114178282
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4195 Issued in AZ
Practice address
1100 S Dobson Rd
Suite 223
Chandler, AZ 85286-6157
Phone
(480) 821-8888
Fax
(480) 821-0888
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4195 AZ Primary
Physician Assistant 363A00000X 00180553 TX
Physician Assistant 363A00000X 50.003768 OH

Addresses

Primary practice location

1100 S Dobson Rd
Suite 223
Chandler, AZ 85286-6157

Mailing address

1100 S Dobson Rd
Suite 223
Chandler, AZ 85286-6157
Phone (480) 821-8888

Other names 1

  • Miss Wendy Ann Thompson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170712004161 AZ Practitioner - Physician Assistant 9335327212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003768OHMDPhysician Assistant
00180553TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group of SL PA Past Accepting new patients
East Valley Dermatology RX, LLC Past Accepting new patients
CH Specialty Services TX PLLC Past Accepting new patients

Organizations & group practices 4

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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Valley Dermatology Center 15 clinicians

Practice addresses (Care Compare)

1100 S Dobson Rd
Chandler, AZ 85286-6160
Phone (480) 821-8888

Merit-based Incentive Payment System (MIPS)

Final score
87.48 of 100Reported as group
Quality
88.21
Improvement activities
40
Cost
73.99

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1114178282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "address_2": "SUITE 223",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-821-8888",
            "fax_number": "480-821-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "address_2": "SUITE 223",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-821-8888",
            "fax_number": "480-821-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDENOUR",
        "first_name": "WENDY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4195",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "00180553",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "THOMPSON",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.