Jeffery George Riddle, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0999 Issued in NC

Practice address

245 N Gordon Dr
Winston Salem, NC 27104-2822

Phone

(336) 529-6835

NPI assigned

May 19, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1861785198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N GORDON DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271042822",
            "telephone_number": "336-529-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N GORDON DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271042822",
            "telephone_number": "336-529-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "JEFFERY",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "0999",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "0999",
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NC",
            "license": "0999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Richter
• Jeff L Rickabaugh, D.D.S., M.D.S., P.A.
• Lakesha Rickard
• Joshua Scott Rickey, M.D.
• Erin Riddle, SRNA
• Judith V Ridge, OPTICIAN
• Amanda Marie Ridgeley
• Racquell Ridgill, RN
• Michele Walker Rieder, COTA/L
• Lisa Rieker, CRNA

• Occupational Therapy Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Occupational Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.