JENTRY DANIELLE RIDDLE PA NPI 1003849837

NPI Information

NPI: 1003849837
Provider Name: JENTRY DANIELLE RIDDLE, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4204 EAST STAN SCHLEUTER LOOP
KILLEEN, TX
ZIP 76542
Phone: (254) 690-2800
Get Directions

Jentry Danielle Riddle, PA is a medical physician assistant in Killeen, TX. Jentry Danielle Riddle, PA NPI is 1003849837. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4204 EAST STAN SCHLEUTER LOOP
KILLEEN, TX
ZIP 76542-352
Phone: (254) 690-2800
Fax: (254) 690-5401

The NPI 1003849837 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 6/15/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		MP00154600	NEW JERSEY	No
2	363A00000X	Physician Assistant		PA05748	TEXAS	No
3	363AM0700X	Physician Assistant	Medical	PA05748	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	8K9597	MEDICARE PIN	TEXAS
2	8K9596	MEDICARE PIN	TEXAS
3	Q65880	MEDICARE UPIN
4	1991747-02	MEDICAID	TEXAS
5	1991747-01	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »