Susan Mercedes Rieble, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4868 Issued in CO

Practice address

1721 E 19TH Ave Ste 300
Denver, CO 80218

Phone

(720) 754-4800

NPI assigned

Sep 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1962711796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-342-1387",
            "fax_number": "480-342-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 E 19TH AVE STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80218",
            "telephone_number": "720-754-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEBLE",
        "first_name": "SUSAN",
        "middle_name": "MERCEDES",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4722",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO PA LICENSE",
            "identifier": "4868",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn J Rider, LPC
• Samantha Sinclair Ridgeway Fulton, CNM, APN
• Ashley Ridilla, RDH
• Jessi Lynn Ridinger, RN
• Dustin R Ridout, MD
• Keri Riechers, PA-C
• Amy Riedel
• Rae Lynn Riedel, D.C.
• Roann Lori Riedel, CMT
• Jane Riedl, MOT, OTR/L

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.