Ridge Medical Group PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

RIDGE MEDICAL GROUP PA

Doing business as

The Ridge Foot and Ankle Center

Practice address

2677 E 17TH St Ste 200
Ammon, ID 83406-6612

Phone

(208) 741-3660

NPI assigned

Aug 9, 2022

Organization subpart

No

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

Authorized official

Name

Braden Jenkins, DPMNPI 1609337682

Title

President

Phone

(208) 881-2100

Specialties & licenses 1

Addresses

Other names 1

• The Ridge Foot and Ankle Center Doing business as

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Braden Jenkins, DPM

  • Foot & Ankle Surgery Podiatrist
  • Ammon, ID
  • NPI 1609337682
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1922736842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 E 17TH ST STE 200",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066612",
            "telephone_number": "208-741-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 E 17TH ST STE 200",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066612",
            "telephone_number": "208-741-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "BRADEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-881-2100",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Ridge Foot and Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Ridge Foot and Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Adelle Reyna
• Lael Jo Reynolds
• Karen Richardson, BS
• Hannah Richey
• Morgan Jesse Ricks
• Whitney Riggs, BS
• Angela Rizzette Rivera
• Dorothy Elaine Roberts, PHARMD
• Jamacie Robin
• Ashlee Kate Robinson

• Foot & Ankle Surgery Podiatrist in Ammon, ID
• Providers in Ammon, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.