Elgerene Monique Ridderheim, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71008116A Issued in IN

Practice address

6279 E State Blvd
Fort Wayne, IN 46815-7641

Phone

(260) 492-0951

NPI assigned

May 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elgerene Monique Ridderheim Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eridderhei@direct.iuhealth.org

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.

• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Indiana University Health Urgent Care Centers, LLC.

  • Urgent Care Clinic/Center
  • Greenwood, IN
  • NPI 1750763819
  Medicare reassignment NPD
• Indiana University Health Fort Wayne Physicians, LLC

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1316550445

  Nurse Practitioner

  NPD
• Indiana University Health Urgent Care Centers, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1972273654
  NPD

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1750871687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6729 EAST STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46815",
            "telephone_number": "260-492-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6279 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157641",
            "telephone_number": "260-492-0951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9821 Lima Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468189281",
            "country_code": "US",
            "telephone_number": "260-234-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11050 Parkview Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "46845",
            "country_code": "US",
            "telephone_number": "833-724-8326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDERHEIM",
        "first_name": "ELGERENE",
        "middle_name": "MONIQUE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008116A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008116A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eridderheim@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9821 Lima Rd Ste 103",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468189281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELGERENE",
            "last_name": "RIDDERHEIM",
            "middle_name": "MONIQUE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hanah Ricketts
• Breanna Rose Rickey, DPT
• Robert Todd Rickman, MD
• Nicholas L Rico, M.D.
• Sarah Riddell
• Courtney N Riddle
• Robin Lee Ann Riddle, NP
• Ride Express 1
• Gregory Ridenour
• Randall J. Rider, MS, LSW, LMFT

• Family Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.