Individual provider Active NPI

Todd Evert Riddle, DC

  • Chiropractor
  • League City, TX
National Provider Identifier
1841420411
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13202 Issued in TX
Practice address
3033 Marina Bay Dr
League City, TX 77573-3984
Phone
(281) 334-9300
Fax
(281) 334-9301
NPI assigned
Jul 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3484 SC
Chiropractor 111N00000X 13202 TX Primary

Addresses

Primary practice location

3033 Marina Bay Dr
League City, TX 77573-3984

Mailing address

3033 Marina Bay Dr
League City, TX 77573-3984
Phone (281) 334-9300

Other practice location 1

5912 Spencer Hwy
Pasadena, TX 77505-1602
Phone (281) 998-5735

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

State licenses

LicenseStateTypeSpecialty
13202TXMDChiropractor
3484SCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Chiropractic and Wellness, LLC Chiropractor PastSince Jul 27, 2010 Accepting new patients
Wise Chiropractic & Rehabilitation, LLC Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1841420411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 MARINA BAY DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733984",
            "telephone_number": "281-334-9300",
            "fax_number": "281-334-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 MARINA BAY DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733984",
            "telephone_number": "281-334-9300",
            "fax_number": "281-334-9301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5912 Spencer Hwy",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775051602",
            "country_code": "US",
            "telephone_number": "281-998-5735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "TODD",
        "middle_name": "EVERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3484",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.