Active NPI
Adam Ridgdell, PT
- Orthopedic Physical Therapist
- Simpsonville, SC
National Provider Identifier
1659612703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Practice address
- 727 SE Main St
Ste 200
Simpsonville, SC 29681-3247 - Phone
- (630) 296-2223
- NPI assigned
- Mar 13, 2013
- Last updated
- Nov 18, 2015
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT019622 | PA | |
| Geriatric Physical Therapist | 2251G0304X | |||
| Sports Physical Therapist | 2251S0007X | |||
| Orthopedic Physical Therapist | 2251X0800X | Primary |
Addresses
Primary practice location
727 SE Main St
Ste 200
Simpsonville, SC 29681-3247
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Past | Accepting new patients |
Interoperability endpoints
- adam.k.ridgdell@upmcdirect.com
Organizations & group practices 2
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.
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- Greenville, SC
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- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447804800000",
"number": "1659612703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 SE MAIN ST",
"address_2": "STE 200",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296813247",
"telephone_number": "630-296-2223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDGDELL",
"first_name": "ADAM",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-13",
"last_updated": "2015-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT019622",
"primary": false
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.