Individual provider Active NPI

Jennifer S. Riebel, M.D.

  • Pediatrics Physician
  • Georgetown, KY
National Provider Identifier
1831200336
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29729 Issued in KY
Practice address
1162 Lexington Rd
Georgetown, KY 40324-9330
Phone
(502) 863-6426
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29729 KY Primary

Addresses

Primary practice location

1162 Lexington Rd
Georgetown, KY 40324-9330

Mailing address

2913 Frankfort Rd
Georgetown, KY 40324-9146
Phone (502) 867-1305

Other identifiers 5

IdentifierTypeStateIssuer
1200220OtherKYUNITED HEALTH CARE
4649312OtherKYAETNA
64297294MedicaidKY
000000049849OtherKYANTHEM
611215814OtherKYBLUEGRASS FAMILY HEALTH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer-riebel@georgetownpeds.e-mdsdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210409001731 KY Practitioner - Pediatric Medicine 6901102656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29729KYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1831200336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 FRANKFORT RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249146",
            "telephone_number": "502-867-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 LEXINGTON RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249330",
            "telephone_number": "502-863-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEBEL",
        "first_name": "JENNIFER",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "29729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1200220",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4649312",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64297294",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000049849",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUEGRASS FAMILY HEALTH",
            "identifier": "611215814",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer-riebel@georgetownpeds.e-mdsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Georgetown Peds",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1162 Lexington Rd",
            "city": "Georgetown",
            "state": "KY",
            "country_code": "US",
            "postal_code": "403249330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.