Active NPI
Keisha Nichole Todd, PHYSICIAN ASSISTANT
- Medical Physician Assistant
- Lexington, KY
National Provider Identifier
1376193250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA2824
- Practice address
- 828 Lane Allen Rd
Lexington, KY 40504-3658 - Phone
- (919) 932-5700
- Fax
- (919) 933-6881
- NPI assigned
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2824 | KY | |
| Medical Physician Assistant | 363AM0700X | 4064 | TN | |
| Medical Physician Assistant | 363AM0700X | |||
| Medical Physician Assistant | 363AM0700X | TC055 | KY | |
| Medical Physician Assistant | 363AM0700X | MT6782482 | KY | |
| Medical Physician Assistant | 363AM0700X | 4832 | TN | |
| Medical Physician Assistant | 363AM0700X | PA2824 | KY | Primary |
Addresses
Primary practice location
828 Lane Allen Rd
Lexington, KY 40504-3658
Mailing address
PO Box 1006
Pine Knot, KY 42635-1006
Phone (606) 310-1812
Other names 1
- Keisha Nichole Ridner
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- 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
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
306 W Main St
Suite 512
Frankfort, KY 40601-1840
Phone (855) 743-2247
828 Lane Allen Rd
Suite 219
Lexington, KY 40504-3659
Phone (260) 483-9081
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4832 | TN | MD | Occupational Therapist |
| PA2824 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Ecs - Kentucky, PLLC | Current | Accepting new patients | |
| Eventus WH Midwest Care, LLC | Physician Assistant | Current | Accepting new patients |
| Preston Urgent Care, Inc | Past | Accepting new patients |
Locations
922 State St
Fl 4
Bowling Green, KY 42101
828 Lane Allen Rd
Ste 219
Lexington, KY 40504
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 and National Provider Directory roles.
-
- Nurse Practitioner
- Lexington, KY
- NPI 1396563276
-
- Urgent Care Clinic/Center
- Louisville, KY
- NPI 1780115998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1376193250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1006",
"city": "PINE KNOT",
"state": "KY",
"postal_code": "426351006",
"telephone_number": "606-310-1812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 LANE ALLEN RD",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405043658",
"telephone_number": "919-932-5700",
"fax_number": "919-933-6881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TODD",
"first_name": "KEISHA",
"middle_name": "NICHOLE",
"name_prefix": "Ms.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-12",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA2824",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TN",
"license": "4064",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KY",
"license": "TC055",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KY",
"license": "MT6782482",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TN",
"license": "4832",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KY",
"license": "PA2824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEISHA",
"last_name": "RIDNER",
"middle_name": "NICHOLE",
"credential": "PHYSICIAN ASSISTANT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.