Active NPI
Robert Low Ridley, MD
- Family Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1164414306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- CO21825
- Practice address
- 2855 Dublin Blvd
Colorado Springs, CO 80918-1662 - Phone
- (719) 265-1902
- Fax
- (719) 574-8405
- NPI assigned
- Aug 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | CO21825 | CO | Primary |
Addresses
Primary practice location
2855 Dublin Blvd
Colorado Springs, CO 80918-1662
Mailing address
2855 Dublin Blvd
Colorado Springs, CO 80918-1662
Phone (719) 265-1902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO21825 | CO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1164414306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2855 DUBLIN BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809181662",
"telephone_number": "719-265-1902",
"fax_number": "719-574-8405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2855 DUBLIN BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809181662",
"telephone_number": "719-265-1902",
"fax_number": "719-574-8405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDLEY",
"first_name": "ROBERT",
"middle_name": "LOW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "CO21825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.