Individual provider Active NPI

Deborah J Riddell, APN. CNM

  • Advanced Practice Midwife
  • Aurora, IL
National Provider Identifier
1760580708
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
309001170 Issued in IL
Practice address
2972 Indian Trail Road
Suite a
Aurora, IL 60502
Phone
(630) 897-7700
Fax
(630) 897-7701
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 309001170 IL Primary

Addresses

Primary practice location

2972 Indian Trail Road
Suite a
Aurora, IL 60502

Mailing address

2040 Ogden Avenue
Suite 313
Aurora, IL 60504
Phone (630) 499-2404

Other identifiers 1

IdentifierTypeStateIssuer
4521469OtherILBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
309001170ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Women First Midwifery Advanced Practice Midwife PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1760580708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 OGDEN AVENUE",
            "address_2": "SUITE 313",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60504",
            "telephone_number": "630-499-2404",
            "fax_number": "630-499-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2972 INDIAN TRAIL ROAD",
            "address_2": "SUITE A",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60502",
            "telephone_number": "630-897-7700",
            "fax_number": "630-897-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDELL",
        "first_name": "DEBORAH",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "APN. CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "309001170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4521469",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.