Active NPI
Kaitlin Ridder, M.D.
- Urology Physician
- Wilmington, NC
National Provider Identifier
1114339447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 2022-00246
- Practice address
- 1905 Glen Meade Rd
Wilmington, NC 28403-6024 - Phone
- (910) 763-6251
- Fax
- (910) 763-7408
- NPI assigned
- May 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | D0087688 | MD | |
| Urology Physician | 208800000X | 2022-00246 | NC | Primary |
Addresses
Primary practice location
1905 Glen Meade Rd
Wilmington, NC 28403-6024
Mailing address
1905 Glen Meade Rd
Wilmington, NC 28403-6024
Phone (910) 763-6251
Other practice location 1
4222 Long Beach Rd SE Ste B
Southport, NC 28461-8627
Phone (910) 763-6251
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2022-00246 | Other | NC | NC MEDICAL BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Tennessee, HSC, College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1905 Glen Meade Rd
Wilmington, NC 28403-6024
Phone (910) 763-6251
Hospital & facility affiliations
- Novant Health New Hanover Regional Medical Center
- J Arthur Dosher Memorial Hospital
- Novant Health Brunswick Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0087688 | MD | MD | Urology Physician |
| 2022-00246 | NC | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urology Associates of Southeastern North Carolina, PA | Current | Accepting new patients | |
| Urology Associates of Southeastern North Carolina, PA | Urology | Past | Accepting new patients |
Locations
4222 Long Beach Rd SE
Ste B
Southport, NC 28461
Phone (910) 763-6251
1905 Glen Meade Rd
Wilmington, NC 28403
Phone (910) 762-3547
Interoperability endpoints
- kridder1467410@direct.novanthealth.org
- kaitlinridder@uasnc.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Specialist
- Wilmington, NC
- NPI 1407875610
-
- Urology Physician
- Southport, NC
- NPI 1689342263
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bolivia, NC
- NPI 1710915756
-
- Rural Health Clinic/Center
- Oak Island, NC
- NPI 1235405358
Hospital
-
- General Practice Physician
- Bald Head Island, NC
- NPI 1376961219
Hospital
-
- Critical Access Hospital
- Southport, NC
- NPI 1538260229
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658880000000",
"number": "1114339447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 GLEN MEADE RD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036024",
"telephone_number": "910-763-6251",
"fax_number": "910-762-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 GLEN MEADE RD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036024",
"telephone_number": "910-763-6251",
"fax_number": "910-763-7408"
}
],
"practiceLocations": [
{
"address_1": "4222 Long Beach Rd SE Ste B",
"address_purpose": "LOCATION",
"city": "Southport",
"state": "NC",
"postal_code": "284618627",
"country_code": "US",
"telephone_number": "910-763-6251",
"fax_number": "910-477-6780",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIDDER",
"first_name": "KAITLIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-21",
"last_updated": "2022-07-27",
"certification_date": "2022-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MD",
"license": "D0087688",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NC",
"license": "2022-00246",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC MEDICAL BOARD",
"identifier": "2022-00246",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.