Staci W Riddling, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21373 Issued in FL

Practice address

534 S 5TH St # a
Macclenny, FL 32063

Phone

(904) 259-1649

NPI assigned

Sep 8, 2005

Last updated

May 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Staci Joice Woodard Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• John Goetze Physical Therapy, Inc

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1942294640
  Medicare reassignment NPD
• H2 Rehabilitation Services of Florida, LLC

  dba H2 Health

  • Rehabilitation Clinic/Center
  • Macclenny, FL
  • NPI 1851981260
  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1881688588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8847",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320060019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 S 5TH ST # A",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "32063",
            "telephone_number": "904-259-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLING",
        "first_name": "STACI",
        "middle_name": "W",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889518000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "WOODARD",
            "middle_name": "JOICE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amit Ranchhod, PHARM.D
• Raynors Pharmacy Inc
• Rejuvene LLC (Rejuvene Family Medicine)
• Brandice Marie Reynoso, APRN-BC
• Madison Rhoden
• Keir A Robey
• Mary Robinson, M.D.
• Jessica Michele Rockswold, P.A.
• Savannah Jade Rogers
• Margaret L. Romeo, D.M.D.

• Physical Therapist in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.