Active NPI
Kenneth Riddle, PHARMD
- Pharmacist
- Anderson, IN
National Provider Identifier
1992426613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26026715A
- Practice address
- 2003 Broadway St
Anderson, IN 46012-1602 - Phone
- (765) 643-1515
- Fax
- (765) 642-1128
- NPI assigned
- Sep 9, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26026715A | IN | Primary |
Addresses
Primary practice location
2003 Broadway St
Anderson, IN 46012-1602
Mailing address
2003 Broadway St
Anderson, IN 46012-1602
Phone (765) 643-1515
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26026715A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1992426613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2003 BROADWAY ST",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460121602",
"telephone_number": "765-643-1515",
"fax_number": "765-642-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2003 BROADWAY ST",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460121602",
"telephone_number": "765-643-1515",
"fax_number": "765-642-1128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDLE",
"first_name": "KENNETH",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-09",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26026715A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.