Brian G Riddle, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

55864 Issued in WI

Practice address

109 N 28TH St E
Superior, WI 54880-6548

Phone

(715) 395-3900

Fax

(715) 395-3936

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: briddle827879@direct.centracare.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.

• Baldwin County EMS

  • Ambulance
  • Milledgeville, GA
  • NPI 1578668224
  NPD (past)
• Fort Yates Indian Health Service Hospital

  • Health Service Clinic/Center
  • Bullhead, SD
  • NPI 1497347579
  NPD (past)
• Fort Yates Indian Health Service Hospital

  • Clinic/Center
  • McLaughlin, SD
  • NPI 1710037288
  NPD (past)
• Mid Dakota Clinic, Inc.

  • Clinic/Center
  • Bismarck, ND
  • NPI 1275587826
  NPD (past)
• Mille Lacs Band of Ojibwe Indians

  dba Ne-Ia-Shing Clinic

  • Federally Qualified Health Center (FQHC)
  • Onamia, MN
  • NPI 1740357169
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1841212487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N 28TH ST E",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548806548",
            "telephone_number": "715-395-3900",
            "fax_number": "715-395-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 28TH ST E",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548806548",
            "telephone_number": "715-395-3900",
            "fax_number": "715-395-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "BRIAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "55864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Rhea, RN
• Danielle Marie Rhinehart, PTA
• Maxine Ann Rhodes, MSE
• Halie Jean Richards, OTR
• Joseph Van Richards, MD
• Ridgewood Recovery, Inc. (The Superior Treatment Center)
• Benjamin Thomas Riebe, DDS
• Mary K Robinson, LICSW
• Carolyn Irene Roe, N. P.
• Anne Leslie Roeser, LICSW

• Family Medicine Physician in Superior, WI
• Providers in Superior, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.