Michael P Ridge (NPI# 1689660813, PAC ID# 5890786669) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1689660813 |
| PAC ID by PECOS | 5890786669 |
| Professional Enrollment ID | I20040624000969 |
| Full Name | Michael P Ridge |
| Organization Legal Name | OLD PUEBLO HEALTHCARE LLC |
| Address |
560 N Camino Mercado Suite 7 Casa Grande AZ 85122-5759 |
| Phone Number | 5208365538 |
| Gender | M |
| Credential | MD |
| Medical School | SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1981 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 4981607512 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030016 | BANNER CASA GRANDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 | 5208365538 | OLD PUEBLO HEALTHCARE LLC |
| 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 | COTTONWOOD MEDICAL CENTER LTD | |
| 286 S Lenzner Ave, Sierra Vista, AZ 85635-5685 | 5204520388 | OLD PUEBLO HEALTHCARE LLC |
| Organization Legal Name | OLD PUEBLO HEALTHCARE LLC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John T Pellerito Jr. | Internal Medicine | Old Pueblo Healthcare LLC | 5981 E Grant Rd, Suite 115, Tucson, AZ 85712-2363 |
| Carolyn B Schooley | Nurse Practitioner | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Craig W Connor | Physician Assistant | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Heather D Jones | Physician Assistant | Old Pueblo Healthcare LLC | 286 S Lenzner Ave, Sierra Vista, AZ 85635-5685 |
| Dustin A Smith | Nurse Practitioner | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Lynn M Kling | Nurse Practitioner | Old Pueblo Healthcare LLC | 286 S Lenzner Ave, Sierra Vista, AZ 85635-5685 |
| Janice L. Fawcett | Nurse Practitioner | Old Pueblo Healthcare LLC | 286 S Lenzner Ave, Sierra Vista, AZ 85635-5685 |
| Kevin G Hall | Physician Assistant | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Catherine Hallmark | Nurse Practitioner | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| John N Herrod | Internal Medicine | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Street Address |
560 N CAMINO MERCADO SUITE 7 |
| City | CASA GRANDE |
| State | AZ |
| Zip | 85122-5759 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey A Jackson | Optometry | Southwestern Eye Center, Ltd | 560 N Camino Mercado, Suite 1, Casa Grande, AZ 85122-5759 |
| Carolyn B Schooley | Nurse Practitioner | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Craig W Connor | Physician Assistant | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Dustin A Smith | Nurse Practitioner | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Cynthia M Hoeft | Nurse Practitioner | Cottonwood Medical Center Ltd | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Kevin G Hall | Physician Assistant | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Taylor G Thompson | Optometry | Southwestern Eye Center, Ltd | 560 N Camino Mercado, Suite 1, Casa Grande, AZ 85122-5759 |
| Catherine Hallmark | Nurse Practitioner | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Nicolas Uzcategui | Ophthalmology | Southwestern Eye Center, Ltd | 560 N Camino Mercado, Suite 1, Casa Grande, AZ 85122-5759 |
| John N Herrod | Internal Medicine | Old Pueblo Healthcare LLC | 560 N Camino Mercado, Suite 7, Casa Grande, AZ 85122-5759 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laurie M King | Clinical Social Worker | 550 E Cottonwood Lane B, Casa Grande, AZ 85122 | |
| Paul E Rosete | Psychologist, Clinical | 1298 E Avenida Grande, Casa Grande, AZ 85122-1006 | |
| Brittany Dawn Silverman | Physician Assistant | Az Dermatology LLC | 1821 N Trekell Rd, Suite 2, Casa Grande, AZ 85122-1705 |
| Joyce Kate Forest | Family Medicine | Az Dermatology LLC | 1821 N Trekell Rd, Suite 2, Casa Grande, AZ 85122-1705 |
| Kelly L Mullins | Nurse Practitioner | Community Intervention Associates Inc. | 1923 N Trekell Rd, Suite 101 102, Casa Grande, AZ 85122-1706 |
| Sangita B Patel | Nurse Practitioner | 1901 N Trekell Rd, Casa Grande, AZ 85122-1770 | |
| Sheri Steincamp | Registered Dietitian Or Nutrition Professional | 1895 N Trekell Rd, Suite 3, Casa Grande, AZ 85122-1774 | |
| Sean P Jenkins | Chiropractic | 1891 N Trekell Rd, Suite 2, Casa Grande, AZ 85122-1792 | |
| Khushali D Shah | Optometry | Matthew Littlejohn Od PC | 1968 N Pearl Rd, Suite 12, Casa Grande, AZ 85122-2023 |
| Matthew K Littlejohn | Optometry | Matthew Littlejohn Od PC | 653 E Cottonwood Ln, Casa Grande Vision Center, Casa Grande, AZ 85122-2023 |
| Find all physicians in zip 85122 | |||
| City | CASA GRANDE |
| Zip Code | 85122 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | CASA GRANDE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Michael P Ridge.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.