David J Riden, MD

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

39916 Issued in GA

Practice address

3747 Roswell Rd Ste 201
Marietta, GA 30062

Phone

(770) 578-2868

NPI assigned

Sep 13, 2005

Last updated

Oct 30, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: driden165671@directwellstar.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• East Tennessee Children's Hospital Association, Inc.

  dba Dolly Parton Children's Hospital Urology

  • Pediatric Urology Physician
  • Knoxville, TN
  • NPI 1568581387
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  dba WellStar West Cobb Medical Center

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1164728770
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Acworth Family Practice, LLC

  • Family Medicine Physician
  • Acworth, GA
  • NPI 1740489103
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1871588277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 ROSWELL RD STE 201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30062",
            "telephone_number": "770-578-2868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 W Clinch Ave",
            "address_2": "Suite130",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379162219",
            "country_code": "US",
            "telephone_number": "865-673-9315",
            "fax_number": "865-673-9316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 W Clinch Ave",
            "address_2": "Suite130",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379162219",
            "country_code": "US",
            "telephone_number": "865-673-9315",
            "fax_number": "865-673-9316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDEN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "GA",
            "license": "39916",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "TN",
            "license": "31240",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3841062",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "driden165671@directwellstar.org",
            "affiliation": "N",
            "address_1": "3747 Roswell Rd Ste 201",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300626227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiberiu Riconte, DDS
• Christopher Riddell, MD
• Summer D Riddick
• Margaret Riddle, LPC
• Sara P. Riddle, NP-C
• Ridgeline Counseling LLC
• Shelby Ridgely
• Ridgewood Personal Care Home, Inc (Ridgewood Cla)
• Jennifer Riemersma, MA, LPC
• Asma Rifay

• Pediatric Urology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.