NPIMap

Individual provider Active NPI

Douglas Ryan Riddle, MD

  • Family Medicine Physician
  • Edmond, OK
National Provider Identifier
1659310928
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23957 Issued in OK
Practice address
4509 Integris Pkwy Ste 200
Edmond, OK 73034-8696
Phone
(405) 657-3950
Fax
(405) 471-0040
NPI assigned
Jun 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23957 OK Primary

Addresses

Primary practice location

4509 Integris Pkwy Ste 200
Edmond, OK 73034-8696

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 657-3950

Other identifiers 1

IdentifierTypeStateIssuer
200079200AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060509000068 OK Practitioner - Family Practice 5496764417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 657-3150

4833 Integris Pkwy
Edmond, OK 73034-8864

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23957OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Classen Urgent Care Clinic LLC CurrentSince Oct 24, 2011 Accepting new patients
Classen Urgent Care Clinic LLC CurrentSince Oct 24, 2011 Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Feb 11, 2013 Accepting new patients
Baha Al Deen Abuesheh MD PC Past Accepting new patients
Integris Ambulatory Care C Orporation Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients
Deaconess Physician Services LLC Family Medicine Past Accepting new patients
Washita Emergency Physicians LLC Past Accepting new patients

Locations

4509 Integris Pkwy
Ste 200
Edmond, OK 73034
Phone (405) 657-3895

2818 Classen Blvd
Norman, OK 73071
Phone (405) 701-7111

11101 Hefner Pointe Dr
Ste 105
Oklahoma City, OK 73120
Phone (405) 604-4936

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

100 Valley Dr
Pauls Valley, OK 73075
Phone (405) 238-5501

Interoperability endpoints

  • Direct secure messaging: driddle14459@direct.integrisok.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659310928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-657-3950",
            "fax_number": "405-471-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 INTEGRIS PKWY STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348696",
            "telephone_number": "405-657-3950",
            "fax_number": "405-471-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "DOUGLAS",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200079200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.