JEREMY RIDDLE (NPI# 1740683044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740683044 |
| Entity Type | Individual |
| Full Name | JEREMY RIDDLE |
| Credential | PT |
| Practice Address |
4 Downwind Ave Greenbrier AR 72058-9815 |
| Mailing Address |
4 Downwind Ave Greenbrier AR 72058 |
| Practice Telephone | 5017305445 |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2014-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
PT2331 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535834 | Jeremy Riddle | Counselor | 455 Portland Ave, Gladstone, OR 97027-2452 | 2019-12-20 |
| 1629303649 | Jeremy A. Riddle | Counselor | 1631 E 2nd St Ste E, Austin, TX 78702-4491 | 2009-10-08 |
| Street Address |
4 DOWNWIND AVE |
| City | GREENBRIER |
| State | AR |
| Zip Code | 72058-9815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296570 | Lauren Michelle Davis | Pharmacist | 61a South Broadview Street, Greenbrier, AR 72058 | 2019-10-10 |
| 1851941751 | Carmen M. Crawford | Technician | 129 Mill Creek Dr., Greenbrier, AR 72058 | 2019-09-13 |
| 1659935476 | Thomas A Bradley | Nurse Practitioner | 20 Wilson Farm Rd, Greenbrier, AR 72058 | 2019-04-26 |
| 1235614421 | Greenbrier Pharmacy Inc | Pharmacy | 61a South Broadview St, Greenbrier, AR 72058 | 2018-10-03 |
| 1912453127 | Sarah Ellington | Speech-Language Pathologist | 8 Wilson Farm Rd Suite F, Greenbrier, AR 72058 | 2016-08-28 |
| 1487056628 | Tammy Dallari | Occupational Therapist | 92 A S Broadview St, Greenbrier, AR 72058 | 2014-09-18 |
| 1427300953 | Elizabeth Mcclelland | Occupational Therapist | 92 A South Broadveiw, Hwy 65, Greenbrier, AR 72058 | 2012-10-08 |
| 1891040564 | Kristina Mcgee | Speech-Language Pathologist | 92 South Broadveiw, Hwy 65, Greenbrier, AR 72058 | 2012-07-19 |
| 1003189606 | Conway Childrens Clinic Pa Corp | Clinic/Center | 10 Lois Lane, Greenbrier, AR 72058 | 2012-02-14 |
| 1861797813 | Harps Food Stores Inc | Pharmacy | 15 North Broadview Street, Greenbrier, AR 72058 | 2011-01-24 |
| Find all providers in zip 72058 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841377751 | Greenbrier Therapy | Physical Therapist | 3 Glendale Cir, Greenbrier, AR 72058-9251 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205346111 | Rehabilitation Network Outpatient Services LLC | Physical Therapist | 93 Roden Mill Rd, Conway, AR 72032-9555 | 2017-10-05 |
| 1891152435 | Tamara Fowler | Physical Therapist | 8319 Geyer Springs Rd, Little Rock, AR 72209-4945 | 2016-01-27 |
| 1285001487 | Jennifer Lynne Hallam | Physical Therapist | 1100 Division St Ste 3, Prairie Grove, AR 72753-5501 | 2015-08-24 |
| 1780069476 | Edith Areli Molina Amaya | Physical Therapist | 2819 W Hillshire Dr, Fayetteville, AR 72704-5137 | 2015-07-23 |
| 1730470998 | Stefanie Hines Schumacher | Physical Therapist | 48 Colt Square, Fayetteville, AR 72703-2813 | 2011-04-22 |
| 1497088918 | Shawna Walter | Physical Therapist | 301 N Sidney Ave, Russellville, AR 72801-4383 | 2009-09-16 |
| 1316199540 | Nancy Renee George | Physical Therapist | 2571 Indian Oaks Trl, Springdale, AR 72762-2592 | 2008-10-21 |
| 1396900676 | Jolynn Pickens | Physical Therapist | 7312 Geronimo Cir, North Little Rock, AR 72116-4363 | 2008-07-25 |
| 1245491224 | The Therapy Spot,llc | Physical Therapist | 3130 Market St., Fayetteville, AR 72703-7519 | 2008-06-22 |
| 1629247150 | Lisa A Anglin | Physical Therapist | 2310 Andrew Ct, Rogers, AR 72756-0222 | 2008-02-28 |
| Find all providers with the same taxonomy | ||||
| City | GREENBRIER |
| Zip Code | 72058 |
Please comment or provide details below to improve the information on JEREMY 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.