Carl Michael Riddell, M.D., F.A.C.O.G.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

C-5991 Issued in AR

Practice address

5800 W 10TH St
Ste.401
Little Rock, AR 72204-1752

Phone

(501) 661-2480

Fax

(501) 661-2464

NPI assigned

May 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Mike Riddell Other name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1497966808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 W 10TH ST",
            "address_2": "STE.401",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041752",
            "telephone_number": "501-661-2480",
            "fax_number": "501-661-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 W 10TH ST",
            "address_2": "STE.401",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041752",
            "telephone_number": "501-661-2480",
            "fax_number": "501-661-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDELL",
        "first_name": "CARL",
        "middle_name": "MICHAEL",
        "credential": "M.D., F.A.C.O.G.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "AR",
            "license": "C-5991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110831001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKE",
            "last_name": "RIDDELL",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Atika Sadou Ricks
• Curtis Ricks
• Jett Samuel Ricks, PHARM.D
• Juan Carlos Rico Crescencio, M.D.
• Ashlee Rico, APRN
• Daniel Riddle, P.D.
• Nicholas Brandon Riddle
• Hayley Elizabeth Riding, PHARMD
• Clifton W. Ridings Jr., O.D.
• Josie E Rieves

• Obstetrics Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Obstetrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.