JORDAN A RIDDER (NPI# 1134648355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134648355 |
| Entity Type | Individual |
| Full Name | JORDAN A RIDDER |
| Other Name | JORDAN A OSBORN |
| Credential | PA-C |
| Practice Address |
4711 Centerline Dr Ste 100 Knoxville TN 37917-1405 |
| Practice Telephone | 8656473260 |
| Practice Fax Number | 8656473279 |
| Mailing Telephone | 8656473260 |
| Mailing Fax Number | 8656473279 |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3418 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q032251 | 05 |
| Street Address |
4711 CENTERLINE DR STE 100 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37917-1405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356322341 | Tina Marie Paul | Nurse Practitioner | 4711 Centerline Dr Ste 100, Knoxville, TN 37917-1405 | 2005-11-08 |
| 1871939793 | Eddie Lamaine Brown | Family Medicine | 4711 Centerline Dr Ste 100, Knoxville, TN 37917-1405 | 2013-05-18 |
| 1881970044 | Christopher Ryan Pivonka | Physician Assistant | 4711 Centerline Dr Ste 100, Knoxville, TN 37917-1405 | 2011-11-01 |
| 1275591505 | Sharon Elaine Glass | Physical Medicine & Rehabilitation | 4711 Centerline Dr Ste 100, Knoxville, TN 37917-1405 | 2006-05-03 |
| 1437128899 | Syed Ahmed | Internal Medicine | 4711 Centerline Dr Ste 100, Knoxville, TN 37917-1405 | 2006-03-16 |
| 1194793679 | Richard Bock | Physician Assistant | 4711 Centerline Dr Ste 100, Knoxville, TN 37917-1405 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033601786 | Angela Marie Barnett | Licensed Practical Nurse | 201 W Springdale Ave # 203, Knoxville, TN 37917 | 2018-05-30 |
| 1790283588 | Kevin Johnson | Case Manager/Care Coordinator | 201 W. Springfield Ave, Knoxville, TN 37917 | 2018-01-26 |
| 1871011437 | Sara Portwood | Registered Nurse | 140 Dameron Ave., Knoxville, TN 37917 | 2017-09-05 |
| 1962926295 | Dara Steele | Counselor | 201 West Springdale, Knoxville, TN 37917 | 2017-07-28 |
| 1043740657 | Stacy Banks | Counselor | 201 West Springdale Ave., Knoxville, TN 37917 | 2017-06-15 |
| 1861921215 | Amy J Mccowan | Registered Nurse | 201 W. Springdale Ave., Knoxville, TN 37917 | 2017-06-08 |
| 1942756523 | Skyler Daegan Winkler | Counselor | 201 West Springvale Avenue, Knoxville, TN 37917 | 2016-09-01 |
| 1821454216 | Beth Cannon | Case Manager/Care Coordinator | 201 West Sprindale Ave, Knoxville, TN 37917 | 2016-01-14 |
| 1760874986 | Sierra Brooke Finley | Case Manager/Care Coordinator | 201 W. Springdale Ave, Knoxville, TENNESSEE 37917 | 2015-02-25 |
| 1568860377 | Megumi Takayama Maynard | Family Medicine | 900 E. Oak Hill Avenue, Knoxville, TN 37917 | 2014-12-10 |
| Find all providers in zip 37917 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770198061 | John Intemann | Physician Assistant | 2708 Swafford Rd, Knoxville, TN 37932-1311 | 2020-09-13 |
| 1942839311 | Melissa Joanne O'neill | Physician Assistant | 814 Landings River Way Unit 301, Knoxville, TN 37915-1444 | 2020-04-07 |
| 1447895370 | Keiana Skinner | Physician Assistant | 2206 Finley Cane Ln, Knoxville, TN 37932-1572 | 2019-11-14 |
| 1780231068 | Kaycee Heitzman | Physician Assistant | 3055 W Gallaher Ferry Rd, Knoxville, TN 37932-1022 | 2019-08-21 |
| 1366009169 | John Powell Williams Iv | Physician Assistant | 501 19th St Ste 503, Knoxville, TN 37916-1874 | 2019-05-28 |
| 1508423369 | Bradley-james Ryan Faulkner | Physician Assistant | 1924 Pinnacle Pointe Way Ste 100, Knoxville, TN 37922-3700 | 2019-05-28 |
| 1316406499 | David M Beauchamp | Physician Assistant | 10714 Silver Leaf Way Apt 104, Knoxville, TN 37931-2758 | 2019-03-18 |
| 1568920593 | Richard Ervin Birmingham II | Physician Assistant | 304 Bagwell Rd, Knoxville, TN 37924-2813 | 2019-03-08 |
| 1710443080 | Devon Meske Herrin | Physician Assistant | 6484 Kingston Pike, Knoxville, TN 37919-4863 | 2019-02-12 |
| 1780149070 | Shelby Paige Bean | Physician Assistant | 7661 Red Bay Way, Knoxville, TN 37919-4722 | 2019-01-31 |
| Find all providers in KNOXVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.