Ridgecrest Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

962 Issued in TN

Legal business name

RIDGECREST MEDICAL LLC

Practice address

1907 W Morris Blvd
Suite 300a
Morristown, TN 37813-3860

Phone

(423) 353-1152

Fax

(423) 353-1157

NPI assigned

Oct 8, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Priscilla Mills

Title

President

Phone

(423) 353-1152

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1124421847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 W MORRIS BLVD",
            "address_2": "SUITE 300A",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378133860",
            "telephone_number": "423-353-1152",
            "fax_number": "423-353-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W MORRIS BLVD",
            "address_2": "SUITE 300A",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378133860",
            "telephone_number": "423-353-1152",
            "fax_number": "423-353-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGECREST MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-353-1152",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "962",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "962",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "962",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Faye Reynolds, DC
• Michelle Lee Rice, LCSW
• Leslie Ann Rich, DNP, WHNP
• Logan Andrew Ricker, M.S. CCC-SLP
• Mariah Summer Ricker, DMD
• Rebecca Michelle Ridgeway
• Carmina Velez Rines, FNP
• Donna Gail Ripley, PTA
• Rebecca Marie Ripley, CNM
• Rippetoe Inc

• Internal Medicine Physician in Morristown, TN
• Providers in Morristown, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.