Jennifer Ridenoure, P.A.C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103460 Issued in FL

Practice address

1330 Riverland Rd
Fort Lauderdale, FL 33312-2961

Phone

(954) 321-9826

Fax

(954) 321-9660

NPI assigned

Aug 20, 2006

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Firaz R Hosein DO PA

  • Internal Medicine Physician
  • Pompano Beach, FL
  • NPI 1376732453
  Medicare reassignment

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912012816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 CAMBRIDGE LN",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330263748",
            "telephone_number": "954-704-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 RIVERLAND RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122961",
            "telephone_number": "954-321-9826",
            "fax_number": "954-321-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDENOURE",
        "first_name": "JENNIFER",
        "credential": "P.A.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292299100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fritz Richardson Jr., CEO, OWNER
• Taylor L Richardson, APRN
• Willie Forrest Richardson Jr., MD
• Danielle Erin Richmond, PA
• Kristi Watson Ricks, OTR/L
• Ridestat LLC
• Toni Rieger, M.S
• Rebecca Alana Riekki
• Claudia Rieman, PH.D., LMHC
• Lawrence Adam Riesz, MD

• Medical Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.