Ridge Road Medical Center PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RIDGE ROAD MEDICAL CENTER PA

Practice address

2306 Ridge Rd
Rockwall, TX 75087-5140

Phone

(972) 771-8316

Fax

(972) 722-9214

NPI assigned

Jun 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carl K McKenney, DO

Title

President

Phone

(972) 771-8316

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Misty Gaylene Hornsby-Odom, FNP

  • Nurse Practitioner
  • Rockwall, TX
  • NPI 1689665374
  NPD (past)
• Michele Suter

  • Family Nurse Practitioner
  • Rockwall, TX
  • NPI 1477912434
  NPD (past)
• Besni Varghese, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1316301609
  NPD (past)
• Gregory Scott Ward, FNP, AGACNP

  • Family Nurse Practitioner
  • Greenville, TX
  • NPI 1609405505

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269561600000",
    "number": "1366488512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 RIDGE RD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875140",
            "telephone_number": "972-771-8316",
            "fax_number": "972-722-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 RIDGE RD",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875140",
            "telephone_number": "972-771-8316",
            "fax_number": "972-722-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE ROAD MEDICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-03-26",
        "status": "A",
        "authorized_official_last_name": "MCKENNEY",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-771-8316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091844301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091844302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard L. Lepard DDS, PC
• Cheryl A Richards, DO
• Brina Richardson, RBT
• Katlyn Richardson
• Jeff Charles Rickert, P.A.
• Christopher Rigg
• Elizabeth Riley
• Rachel Rios
• David W Ritter, M.D.
• Jenice Rivera

• Family Medicine Physician in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.