Bruce Clayton Riddle, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6719 Issued in NC

Practice address

150 Veterans Blvd
Bryson City, NC 28713

Phone

(828) 488-2211

Fax

(828) 488-8237

NPI assigned

Dec 28, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• East Carolina University

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1972551919
  Medicare reassignment NPD
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1043260474
  NPD
• East Carolina University

  • Dentist
  • Greenville, NC
  • NPI 1669750014
  NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306902382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "address_2": "150 VETERANS BLVD",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "28713",
            "telephone_number": "828-488-2211",
            "fax_number": "828-488-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VETERANS BLVD",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "28713",
            "telephone_number": "828-488-2211",
            "fax_number": "828-488-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "BRUCE",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990031",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90031",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel L Peterson, PT
• Alaina Presley
• Procor
• John Thomas Pruett
• Christopher Harrison Randazzo, PT
• Valerie Leigh Rigg, M.D.
• RN Consultants, PC
• David Craig Saltin, PA-C
• Michael Anthony Shannon, CNA
• Veronica Dawson Sharp, PA-C

• Dentist in Bryson City, NC
• Providers in Bryson City, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.