Charles Guy Riddle, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-1978 Issued in ID

Practice address

1626 S Wells Ave Ste 105
Meridian, ID 83642-4528

Phone

(208) 789-0200

Fax

(208) 288-2784

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

I Can PT LLCGroup PAC ID 6507180312, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• I Can PT LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1194129817
  Medicare reassignment Care Compare group
• Advanced Family Medicine PLLC

  • Family Medicine Physician
  • Kuna, ID
  • NPI 1598822231
  NPD (past)
• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1366536609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 W MILANO DR",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467290",
            "telephone_number": "208-895-0022",
            "fax_number": "208-898-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 S WELLS AVE STE 105",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424528",
            "telephone_number": "208-789-0200",
            "fax_number": "208-288-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "CHARLES",
        "middle_name": "GUY",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "RPT-1978",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Richardson
• Kami Lynn Richins, PHARMD
• Lester Albert Richins, DMD
• Chase Ricker
• Clayton Ryan Rickles, PHARMD
• Ridgeview Family Health Inc
• Brandon Keith Riebling, D.C.
• Anne E. Riffle, M.D.
• Amy Faye Rigenhagen
• Garren Riggers, DDS

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.