BRANDON RIDDLE (NPI# 1205455730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205455730 |
| Entity Type | Individual |
| Full Name | BRANDON RIDDLE |
| Practice Address |
1711 Ashley Cir Ste 6 Bowling Green KY 42104-5801 |
| Mailing Address |
380 Suwannee Trail St Bowling Green KY 42103-7956 |
| Practice Telephone | 2709015000 |
| Practice Fax Number | 2708425268 |
| Mailing Telephone | 2709015000 |
| Mailing Fax Number | 2708425268 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1711 ASHLEY CIR STE 6 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42104-5801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548806441 | Hillary S Bacon | Social Worker | 1711 Ashley Cir Ste 6, Bowling Green, KY 42104-5801 | 2019-11-26 |
| 1851925242 | Latonya Kees | Case Manager/Care Coordinator | 1711 Ashley Cir Ste 6, Bowling Green, KY 42104-5801 | 2020-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822042 | Ashley Marie Sterchi | Speech-Language Pathologist | The Kid Spot Center, 944 Fields Dr. #102, Bowling Green, KY 42104 | 2020-08-20 |
| 1093339111 | Rachel Marie Held | Specialist/Technologist | 886c Lynnwood Way, Apt. #7, Bowling Green, KY 42104 | 2020-06-04 |
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1487122099 | Candice Spencer | Specialist/Technologist, Other | 1945 Scottsville Rd B2 Pmb 397, Bowling Green, KY 42104 | 2018-11-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1841731494 | Olivia Catherine Sanders | Speech-Language Pathologist | 954 Aristides Dr, Bowling Green, KY 42104 | 2017-03-15 |
| 1376901488 | Trung Trinh | Pharmacist | 1530 Campbell Lane, Bowling Green, KY 42104 | 2016-02-03 |
| 1225409121 | Adam Wesley Baird | Optometrist | 760 Campbell Lane, Suite 120, Bowling Green, KY 42104 | 2015-10-18 |
| 1851797898 | Michelle Leigh King | Speech-Language Pathologist | 829 Mandarin Ave., Bowling Green, KY 42104 | 2014-11-18 |
| Find all providers in zip 42104 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881204212 | Kada Essig | Peer Specialist | 308 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2020-07-31 |
| 1891302055 | Jerhett Burney | Peer Specialist | 330 E 10th Ave, Bowling Green, KY 42101-2110 | 2020-09-30 |
| 1588293021 | Jasmine Cooper | Peer Specialist | 1500 Parkside Dr, Bowling Green, KY 42101-2756 | 2020-04-06 |
| 1780217711 | Joshua R Carter | Peer Specialist | 1312 Westen St, Bowling Green, KY 42104-3352 | 2020-02-18 |
| 1871147181 | Gretchen Denney | Peer Specialist | 380 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2019-07-25 |
| 1235797192 | Crystal Marie Higdon | Peer Specialist | 380 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2019-06-04 |
| 1447816871 | Stacy Crews | Peer Specialist | 380 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2019-05-10 |
| 1366006892 | Jordan Bean | Peer Specialist | 380 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2019-04-30 |
| 1609430271 | Rutuja Chinchankar | Peer Specialist | 380 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2019-04-29 |
| 1215490743 | Steffan Willoughby | Peer Specialist | 380 Suwannee Trail St, Bowling Green, KY 42103-7956 | 2019-04-11 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 42104 |
Please comment or provide details below to improve the information on BRANDON RIDDLE.
| 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.