Individual provider Active NPI

Celia Janette Ridley, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1174817167
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
LL33550 Issued in SC
Practice address
890 W Faris Rd
Mmob Suite 470
Greenville, SC 29605-4253
Phone
(864) 455-7887
Fax
(864) 455-6875
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X LL33550 SC Primary

Addresses

Primary practice location

890 W Faris Rd
Mmob Suite 470
Greenville, SC 29605-4253

Mailing address

890 W Faris Rd
Mmob Suite 470
Greenville, SC 29605-4253
Phone (864) 455-7887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171103002814 SC Practitioner - Obstetrics/Gynecology 8426206095 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL33550SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg South Carolina PC Obstetrics & Gynecology CurrentSince Nov 3, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Obstetrics & Gynecology CurrentSince Feb 1, 2024 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1174817167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD",
            "address_2": "MMOB SUITE 470",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054253",
            "telephone_number": "864-455-7887",
            "fax_number": "864-455-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W FARIS RD",
            "address_2": "MMOB SUITE 470",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054253",
            "telephone_number": "864-455-7887",
            "fax_number": "864-455-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDLEY",
        "first_name": "CELIA",
        "middle_name": "JANETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "LL33550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.