Tice Ridley

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Practice address

19717 Bower Rd
Dade City, FL 33523-6867

Phone

(773) 859-9006

Fax

(727) 499-7526

NPI assigned

Jun 3, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The Circle of Veterans and Families, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Dade City, FL
  • NPI 1174902902
  NPD (past) Authorized official

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1285258368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337440406",
            "telephone_number": "866-410-3774",
            "fax_number": "727-499-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19717 BOWER RD",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335236867",
            "telephone_number": "773-859-9006",
            "fax_number": "727-499-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDLEY",
        "first_name": "TICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rehab Inc
• Violet Reid
• Kirsten T Rhoden, APRN
• Jocelyn Suzanne Richardson, M.A., C.C.C.,SLP
• Ride With Class Wheelchair Transport LLC
• Danelis M Rivera Padilla
• David Ralph Roberts Jr., PT
• Kristin Robinson, PHARMD
• Myrna Rogers
• Samantha Rojas

• Adult Care Home Facility in Dade City, FL
• Providers in Dade City, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.