Individual provider Active NPI

Brandi Leigh Riddick, CRNP

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1700434958
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SP019388 Issued in PA
Practice address
1251 S Cedar Crest Blvd Ste 102a
Allentown, PA 18103-6205
Phone
(610) 402-3940
NPI assigned
Aug 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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 SP019388 PA Primary

Addresses

Primary practice location

1251 S Cedar Crest Blvd Ste 102a
Allentown, PA 18103-6205

Mailing address

1105 Oak St
Coplay, PA 18037-1703
Phone (484) 661-3166

Other practice location 1

6451 Village Ln
Macungie, PA 18062-8484
Phone (610) 967-2772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191227001629 PA Practitioner - Nurse Practitioner 5597199562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1251 S Cedar Crest Blvd
102A LVPG Family Medicine
Allentown, PA 18103-6205
Phone (610) 402-3940

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Family Medicine CurrentSince Nov 18, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 18, 2019 Accepting new patients
Lehigh Valley Physician Group Family Medicine Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1251 S Cedar Crest Blvd
Ste 102A
Allentown, PA 18103
Phone (610) 402-3940

1101 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 240-4073

6451 Village Ln
Macungie, PA 18062
Phone (610) 967-2772

Organizations & group practices 5

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

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1700434958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 OAK ST",
            "city": "COPLAY",
            "state": "PA",
            "postal_code": "180371703",
            "telephone_number": "484-661-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD STE 102A",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036205",
            "telephone_number": "610-402-3940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6451 Village Ln",
            "address_purpose": "LOCATION",
            "city": "Macungie",
            "state": "PA",
            "postal_code": "180628484",
            "country_code": "US",
            "telephone_number": "610-967-2772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDICK",
        "first_name": "BRANDI",
        "middle_name": "LEIGH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP019388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.