Active NPI
Katherine Riddle, AGACNP-BC
- Acute Care Nurse Practitioner
- Southgate, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 4704318916
- Practice address
- 15750 Northline Rd
Southgate, MI 48195-2378 - Phone
- (734) 357-0505
- Fax
- (734) 357-0506
- NPI assigned
- Aug 15, 2023
- Last updated
- Aug 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 4704318916 | MI | Primary |
Addresses
Primary practice location
15750 Northline Rd
Southgate, MI 48195-2378
Mailing address
205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800
Other practice location 1
205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800
Other practice location 2
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kriddle1252907@epic00.shdirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Michigan Medical School, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
205 N E Ave
Jackson, MI 49201-1753
Phone (217) 787-9322
28100 Grand River Ave
Farmington Hills, MI 48336-5970
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.a. Foote Memorial Hospital, Inc | Nurse Practitioner | Current | Accepting new patients |
| W.a. Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Nurse Practitioner | Current | Accepting new patients |
| Fadi Delly, MD PC | Current | Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Past | Accepting new patients |
Locations
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000
3601 W 13 Mile Rd
Royal Oak, MI 48073
15750 Northline Rd
Southgate, MI 48195
Phone (248) 798-3130
7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580
2211 Fort St
Wyandotte, MI 48192
Phone (734) 246-5705
Interoperability endpoints
- kriddle1252907@epic00.shdirect.org
- kriddle886803@direct.hfhs.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
dba Henry Ford Allegiance Health
- Nurse Practitioner
- Jackson, MI
- NPI 1629000708
-
dba Premier Neurology & Pain Specialists
- Interventional Pain Medicine Physician
- Wyandotte, MI
- NPI 1992170187
-
dba Henry Ford Allegiance Health
- Nurse Practitioner
- Jackson, MI
- NPI 1366988347
-
dba Henry Ford Allegiance Health
- Physician Assistant
- Jackson, MI
- NPI 1538606348
-
dba Henry Ford Allegiance Health
- Emergency Medicine Physician
- Jackson, MI
- NPI 1265487722
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Henry Ford Allegiance Health
- General Acute Care Hospital
- Jackson, MI
- NPI 1053403402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1336922244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-205-4800",
"fax_number": "517-205-1713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15750 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952378",
"telephone_number": "734-357-0505",
"fax_number": "734-357-0506"
}
],
"practiceLocations": [
{
"address_1": "205 N East Ave",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MI",
"postal_code": "492011753",
"country_code": "US",
"telephone_number": "517-205-4800",
"fax_number": "517-205-1713",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIDDLE",
"first_name": "KATHERINE",
"credential": "AGACNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MI",
"license": "4704318916",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kriddle1252907@epic00.shdirect.org",
"affiliation": "N",
"address_1": "3601 W 13 Mile Rd",
"city": "Royal Oak",
"state": "MI",
"country_code": "US",
"postal_code": "480736712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.