Tim M Ridgway, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

3422 Issued in SD

Practice address

1500 W 22ND St
Ste 101
Sioux Falls, SD 57105-1503

Phone

(605) 328-8500

Fax

(605) 328-8501

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1295730356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9556",
            "fax_number": "605-328-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W 22ND ST",
            "address_2": "STE 101",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051503",
            "telephone_number": "605-328-8500",
            "fax_number": "605-328-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGWAY",
        "first_name": "TIM",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SD",
            "license": "3422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002424",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lexis Marie Ricke, PA-C
• Andrew John Ridder, M.D.
• Glenn A. Ridder, MD
• Rodney E Ridenour, PAC
• Blake Michael Ridgway, D.D.S.
• Kayler Ridl, LPC
• Brian Abram Rieb, MD
• Brian Lloyd Riedel, LPC LMFT
• G Patrick Riedmann Jr, PA-C
• Thomas J Rieger

• Gastroenterology Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Gastroenterology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.