Mitchell Paul Rider, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

DPM0000000778 Issued in TN

Practice address

BLDG 20 Memorial Ave
Mountain Home, TN 37684-4000

Phone

(423) 926-1171

NPI assigned

Jul 24, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1790160364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL CMP LJN PDTRY",
            "address_2": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28547",
            "telephone_number": "910-450-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 20 MEMORIAL AVE",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Hospital CMP LJN PDTRY",
            "address_2": "100 Brewster Blvd",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "28547",
            "country_code": "US",
            "telephone_number": "910-450-3785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDER",
        "first_name": "MITCHELL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "DPM0000000778",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "DPM0000000778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard R Reece, M.D.
• Judith Ellen Reid, MD MPH
• Evelyn Marie Reilman, R.D.
• Gollakota Satya Rekha, M.D.
• Jody Elaine Rice, MS-CCC-SLP
• Kristal Mills Riska, AUD, PHD
• Shellie Ann Rivers, PHARMD
• Danette Elaine Roark, RRT
• Margaret Grills Roberts, RDH
• Nancy Hughes Roberts, CRNA

• Foot & Ankle Surgery Podiatrist in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Foot & Ankle Surgery Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.