KRYSTYN RIDDLE (NPI# 1619242781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619242781 |
| Entity Type | Individual |
| Full Name | KRYSTYN RIDDLE |
| Credential | PA-C |
| Practice Address |
100 Mimosa Dr Thomasville GA 31792-6676 |
| Practice Telephone | 2292268881 |
| Practice Fax Number | 2295845964 |
| Mailing Telephone | 2292268881 |
| Mailing Fax Number | 2295845964 |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2020-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
002270 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 MIMOSA DR |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-6676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073597753 | Timothy G Grayson | Urology | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2005-12-06 |
| 1902397672 | Fran Maureen Johnson | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2018-05-29 |
| 1619336898 | Archbold Medical Group, Inc. | Urology | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2016-02-17 |
| 1568862068 | Bianca Kierce | Nurse Practitioner | 100 Mimosa Dr, Third Floor, Thomasville, GA 31792-6676 | 2014-09-03 |
| 1871929364 | Leslie C. Stanaland | Nurse Practitioner | 100 Mimosa Dr, 2nd Floor, Thomasville, GA 31792-6676 | 2013-09-17 |
| 1649543497 | Kelly M Ledger | Nurse Practitioner | 100 Mimosa Dr, 2nd Floor, Thomasville, GA 31792-6676 | 2012-02-09 |
| 1205119005 | Ivey E. Allen | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-09-28 |
| 1598057655 | Archbold Medical Group | Surgery | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-05-09 |
| 1760771356 | Mary Kathryn Hanisee | Surgery | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-04-04 |
| 1376832261 | Cianna Pender | Surgery | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942715123 | Jennifer Langdon | Physician Assistant | 100 Mimosa Dr # 3, Thomasville, GA 31792-6676 | 2017-12-09 |
| 1033736269 | Megan Elizabeth Gerrells | Physician Assistant | 100 Mimosa Dr Fl 3, Thomasville, GA 31792-6676 | 2020-07-04 |
| 1356720163 | Jonathan Mark Adams | Physician Assistant | 211 Old Lexington Rd, Thomasville, NC 27360-3428 | 2015-05-26 |
| 1205119005 | Ivey E. Allen | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-09-28 |
| 1154356848 | Plantation Gynecology | Physician Assistant | 814 Gordon Ave, Thomasville, GA 31792-6611 | 2006-07-11 |
| 1124008602 | Melissa H Porter | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748409 | Jesse Aaron Denson | Physician Assistant | 2046 Point Grey Ct Nw, Kennesaw, GA 30152-8276 | 2020-10-20 |
| 1568074227 | James D Craig | Physician Assistant | 3210 New College Way, Cumming, GA 30041-2896 | 2020-08-23 |
| 1982223244 | Keith Hawkins | Physician Assistant | 8498 Glenview St, Douglasville, GA 30134-5639 | 2020-04-15 |
| 1639704307 | Spectrum Surgical LLC | Physician Assistant | 3142 Highway 278 Nw # 135, Covington, GA 30014-2304 | 2020-03-03 |
| 1255962205 | Songthu Nguyen | Physician Assistant | 6119 Foxcroft Ct, Morrow, GA 30260-1069 | 2020-01-29 |
| 1265071229 | Stellar Surgical Assisting | Physician Assistant | 3446 Winder Hwy Ste M-322, Flowery Branch, GA 30542-3007 | 2019-12-22 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1710528401 | Hannah Ingrid Boomgarden | Physician Assistant | 1467 Harper Street Hb 5040, Augusta, GA 30912-5775 | 2019-10-03 |
| 1891257028 | Symmetry Surgical Billing LLC | Physician Assistant | 5135 Mirror Lake Dr, Cumming, GA 30028-7216 | 2019-04-05 |
| Find all providers with the same taxonomy | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
Please comment or provide details below to improve the information on KRYSTYN 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.