Mark A Riddle, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

D0045696 Issued in MD

Practice address

5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393

Phone

(410) 837-2050

Fax

(866) 629-0091

NPI assigned

Jun 12, 2006

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

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316989304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-837-2050",
            "fax_number": "866-629-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 370",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452393",
            "telephone_number": "410-837-2050",
            "fax_number": "866-629-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0045696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162501200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Yvette Richburg, CRNA
• Suzanne L. Ricklin, LCSW-C, BCD, CEDS
• Riddhirx LLC
• Candance Michele Riddick, M.ED, RN CD
• Michelle Riddick
• Joshua Owen Ridenour, LCSW-C
• Andrea Ceresa Ridgeway, D.O.
• Asia Ridley
• Matthew Riggins
• Rightplace Family Clinic

• Child & Adolescent Psychiatry Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Child & Adolescent Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.