Individual provider Active NPI

Robert M Ridout, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Texarkana, TX
National Provider Identifier
1710967146
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
F7096 Issued in TX
Practice address
2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone
(903) 614-2850
Fax
(903) 614-6349
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X F7096 TX Primary

Addresses

Primary practice location

2600 Saint Michael Dr
Texarkana, TX 75503-2372

Mailing address

PO Box 3780
Tupelo, MS 38803-3780

Other identifiers 3

IdentifierTypeStateIssuer
1710967146OtherNPI
P00063095OtherTXRR MEDICARE
038077601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX, OK3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110316000496 AR Practitioner - Pathology 5092618322
I20130626000140 TX Practitioner - Pathology 5092618322 Reassigns benefits to 1 organization
I20201119001890 OK Practitioner - Pathology 5092618322

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Southwestern Medical School at Dallas, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texarkana Gastroenterology Consultants, PAGroup PAC ID 0345212817, 18 clinicians

Practice addresses (Care Compare)

1920 Moores LN
Suite a
Texarkana, TX 75503-4660
Phone 90379280302080

Merit-based Incentive Payment System (MIPS)

Final score
88.74 of 100Reported as group
Quality
77.47
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
71.66 of 100Reported as group
Quality
66.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F7096TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Delta Pathology Group LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 10, 2020 Accepting new patients
Texarkana Gastroenterology Consultants, PA CurrentSince Feb 8, 2013 Accepting new patients
The Delta Pathology Group, L.L.C. Past Accepting new patients

Locations

130 Medical Cir
Nashville, AR 71852
Phone (501) 624-7700

2915 Missouri Ave
Shreveport, LA 71109
Phone (318) 364-2000

3000 Knight St
Ste 220
Shreveport, LA 71105
Phone (318) 841-9526

1301 E Lincoln Rd
Idabel, OK 74745
Phone (580) 208-3103

1920 Moores Ln
Ste A
Texarkana, TX 75503
Phone (903) 792-8030

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • FHIR API: https://ab0ad0d3-1a1d-47a7-80b0-c0bd276b844e.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1710967146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3780",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032372",
            "telephone_number": "903-614-2850",
            "fax_number": "903-614-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDOUT",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "F7096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1710967146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00063095",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038077601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.