Ridglea Senior Living 2015, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RIDGLEA SENIOR LIVING 2015, LLC

Doing business as

The Ridglea Senior Living

Practice address

4109 Westridge Ave
Fort Worth, TX 76116-7410

Phone

(817) 386-8251

NPI assigned

Mar 6, 2018

Organization subpart

No

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

Authorized official

Name

Tanner Stierwalt

Title

Operations

Phone

(817) 851-5805

Specialties & licenses 1

Addresses

Other names 1

• The Ridglea Senior Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1609378603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 MAIN ST STE 2300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761025304",
            "telephone_number": "817-851-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 WESTRIDGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167410",
            "telephone_number": "817-386-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGLEA SENIOR LIVING 2015, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "STIERWALT",
        "authorized_official_first_name": "TANNER",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "817-851-5805"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Ridglea Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amie Wolverton Riddle, PMHNP-BC
• Jonathan Dru Riddle, CRNA
• Yvonne Riddle, APRN, NNP
• Ride N' Safe, LLC
• Ride4Health DFW
• Danielle Ridley
• Joshua Nelton Riechers, MD
• Nathaniel C Ried, D.P.T.
• Adam Harris Riedel, PT, DPT
• Stephen Louis Rieder, PT, DPT

• Assisted Living Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.