Individual provider Active NPI

Elizabeth Riddle, CRNP

  • Nurse Practitioner
  • Tullahoma, TN
National Provider Identifier
1891240743
Registry record updated Jul 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
196188 Issued in TN
Practice address
1805 N Jackson St Ste 11
Tullahoma, TN 37388
Phone
(931) 455-9118
NPI assigned
Aug 22, 2016
Last updated
Jul 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-140718 AL
Nurse Practitioner 363L00000X 196188 TN Primary

Addresses

Primary practice location

1805 N Jackson St Ste 11
Tullahoma, TN 37388

Mailing address

1805 N Jackson St Ste 11
Tullahoma, TN 37388-2275
Phone (931) 455-9118

Other practice location 1

1 Hospital Dr SW
Huntsville, AL 35801-6455
Phone (256) 429-4000

Other practice location 2

1 Hospital Dr SW
Huntsville, AL 35801-6455
Phone (256) 429-4000

Other practice location 3

809 Shoney Dr SW Ste 202
Huntsville, AL 35801-5309
Phone (256) 883-0098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181008001474 TN Practitioner - Nurse Practitioner 8325390008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1503 Hatcher LN
Suite 201
Columbia, TN 38401-4833
Phone (931) 381-4090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-140718ALMDNurse Practitioner
196188TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospices of America - Tennessee, LLC CurrentSince Aug 13, 2018 Accepting new patients
Associates in Gastroenterology, PC Past Accepting new patients
Community Hospices of America - Tennessee, LLC PastSince Aug 6, 2019 Accepting new patients
Associates in Gastroenterology, PC Past Accepting new patients

Locations

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

1503 Hatcher Ln
Ste 200
Columbia, TN 38401
Phone (931) 236-3116

1503 Hatcher Ln
Ste 201
Columbia, TN 38401
Phone (931) 381-4090

181 Prosser Rd
Lawrenceburg, TN 38464
Phone (931) 766-3745

1805 N Jackson St
Ste 11
Tullahoma, TN 37388
Phone (931) 455-9118

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564272000000",
    "number": "1891240743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N JACKSON ST STE 11",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882275",
            "telephone_number": "931-455-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N JACKSON ST STE 11",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-455-9118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358016455",
            "country_code": "US",
            "telephone_number": "256-429-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hospital Dr SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358016455",
            "country_code": "US",
            "telephone_number": "256-429-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 Shoney Dr SW Ste 202",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015309",
            "country_code": "US",
            "telephone_number": "256-883-0098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2019-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-140718",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "196188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.