Active NPI
Bruce W Riddle, MD
- Internal Medicine Physician
- Columbus, IN
National Provider Identifier
1932136744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01044582A
- Practice address
- 2326 18TH St
Ste 210
Columbus, IN 47201-5359 - Phone
- (812) 372-8426
- Fax
- (812) 372-8301
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01044582A | IN | Primary |
Addresses
Primary practice location
2326 18TH St
Ste 210
Columbus, IN 47201-5359
Mailing address
2326 18TH St
Ste 210
Columbus, IN 47201-5359
Phone (812) 372-8426
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054468P | Other | SIHO | |
| 200056040 | Medicaid | IN | |
| 1790837789 | Other | IN | GROUP NPI |
| 00000056040 | Other | ANTHEM | |
| P00137831 | Other | IN | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01044582A | IN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399334400000",
"number": "1932136744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2326 18TH ST",
"address_2": "STE 210",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472015359",
"telephone_number": "812-372-8426",
"fax_number": "812-372-8301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2326 18TH ST",
"address_2": "STE 210",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472015359",
"telephone_number": "812-372-8426",
"fax_number": "812-372-8301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDLE",
"first_name": "BRUCE",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2014-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01044582A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIHO",
"identifier": "054468P",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200056040",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1790837789",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "00000056040",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00137831",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.