Kelli Knox Riddle, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA440 Issued in AL

Practice address

1543 Professional Pkwy
Auburn, AL 36830-2858

Phone

(334) 821-9308

Fax

(850) 522-8354

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL

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

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark D. Herron, M.D. L.L.C.Group PAC ID 9234179128, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

57.01 of 100Reported as group

Quality

10

Improvement activities

40

Cost

76.7

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kelli.riddle@gcd.eclinicaldirectplus.com

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.

• Mark D. Herron, M.D. L.L.C.

  • Dermatology Physician
  • Montgomery, AL
  • NPI 1104897073
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1801938394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 PROFESSIONAL PKWY",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302858",
            "telephone_number": "334-821-9308",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 PROFESSIONAL PKWY",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368302858",
            "telephone_number": "334-821-9308",
            "fax_number": "850-522-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "KELLI",
        "middle_name": "KNOX",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529920250",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009913716",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009913717",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richelle Rice
• Amber Richardson
• Kamryn D Richardson
• Alexander Richter, DMD
• Tristan Richter, ATC
• Harrison Riggs
• Camille Barnett Rivenbark, PHARMACIST
• Laura Robbins, PHARMACIST
• James Michael Roberts, A.T.,C.
• Jarrod Stewart Roberts, M.D.

• Physician Assistant in Auburn, AL
• Providers in Auburn, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; 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.