NPIMap

Individual provider Active NPI

Gary D Riddle, M.D.

  • Family Medicine Physician
  • Newburgh, IN
National Provider Identifier
1942223839
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
IN01043786 Issued in IN
Practice address
100 St Marys Epworth Xing # B100
Newburgh, IN 47630-9497
Phone
(812) 469-8300
NPI assigned
Jul 25, 2006
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IN01043786 IN Primary

Addresses

Primary practice location

100 St Marys Epworth Xing # B100
Newburgh, IN 47630-9497

Mailing address

100 St Marys Epworth Xing # B100
Newburgh, IN 47630-9497

Other practice location 1

115 S Main St
Ferdinand, IN 47532-9534
Phone (812) 367-1906

Other identifiers 2

IdentifierTypeStateIssuer
080112157OtherINRAILROAD MEDICARE
100369570MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000386 IN Practitioner - Family Practice 1759475577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

115 S Main St
Ferdinand, IN 47532-9534
Phone (812) 367-1906

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
IN01043786INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Memorial Medical Center Inc Family Medicine Current Accepting new patients
Deaconess Clinic, Inc Family Medicine CurrentSince Jan 7, 2026 Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Jan 7, 2026 Accepting new patients
Deaconess Memorial Medical Center Inc Family Medicine CurrentSince May 31, 2002 Accepting new patients
Deaconess Memorial Medical Center Inc Past Accepting new patients
Deaconess Clinic, Inc Family Medicine Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

115 S Main St
Ferdinand, IN 47532
Phone (812) 367-1906

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

Interoperability endpoints

  • Direct secure messaging: griddle1041840@direct.deaconess.com

Organizations & group practices 7

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1942223839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING # B100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING # B100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497",
            "telephone_number": "812-469-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 S Main St",
            "address_purpose": "LOCATION",
            "city": "Ferdinand",
            "state": "IN",
            "postal_code": "475329534",
            "country_code": "US",
            "telephone_number": "812-367-1906",
            "fax_number": "812-367-2487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "GARY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "IN01043786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080112157",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100369570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.