Active NPI
Jay Riddle, M.D.
- Military Health Care Provider
- Fort Belvoir, VA
National Provider Identifier
1457341893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 54289
- Practice address
- 9501 Farrell Rd
Suite GC-11
Fort Belvoir, VA 22060-5901 - Phone
- (703) 805-0193
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 54289 | VA | Primary |
Addresses
Primary practice location
9501 Farrell Rd
Suite GC-11
Fort Belvoir, VA 22060-5901
Mailing address
PO Box 1327
Fort Belvoir, VA 22060-1027
Phone (703) 805-0193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54289 | VA | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269561600000",
"number": "1457341893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1327",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220601027",
"telephone_number": "703-805-0193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9501 FARRELL RD",
"address_2": "SUITE GC-11",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220605901",
"telephone_number": "703-805-0193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDLE",
"first_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2010-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "VA",
"license": "54289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Belvoir, VA
Sources for this page
- 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.