Ridge Pathology Consultants

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

RIDGE PATHOLOGY CONSULTANTS

Practice address

200 Avenue F NE
Dept. of Pathology
Winter Haven, FL 33881-4131

Phone

(863) 293-1121

Fax

(863) 291-6071

NPI assigned

Nov 14, 2005

Organization subpart

No

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

Authorized official

Name

Larry D. Botz, M.D.

Title

President

Phone

(863) 293-1121

Specialties & licenses 1

Addresses

Other identifiers 2

Networks

• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1730161068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144333",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328144333",
            "telephone_number": "407-422-9831",
            "fax_number": "407-648-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AVENUE F NE",
            "address_2": "DEPT. OF PATHOLOGY",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814131",
            "telephone_number": "863-293-1121",
            "fax_number": "863-291-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE PATHOLOGY CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "BOTZ",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-293-1121",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061509900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL6584",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberlee Cheyann Richardsone
• Melanie Richter, OTR
• Jordan Silvey Rickman, RD
• Colleen M Riddle, R.N.
• Jerilynn Riddle
• Ridgewood Emergency Group, LLC
• Jackie Righetti, LPT
• Diana Sophia Riley
• Kayla Riley
• Cynthia Ripperger-Soruco

• Anatomic Pathology & Clinical Pathology Physician in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.