DR. KIMBERLY CECIL-RIDDLE (NPI# 1215171251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215171251 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY CECIL-RIDDLE |
| Credential | DNP, APRN, FNP-BC |
| Practice Address |
2801 Walter Garrett Lane Oak Grove KY 42262 |
| Practice Telephone | 2706405821 |
| Practice Fax Number | 8442705587 |
| Mailing Telephone | 2706405821 |
| Mailing Fax Number | 8442705587 |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2016-07-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3004526 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICARE: INDIVIDUAL | K202700 | 01 |
| KY | 7100395690 | 05 | |
| TRICARE | 474415234 | 01 | |
| KY | MEDICARE GROUP (ST. MICHAEL'S) | K202701 | 01 |
| TN | Q020269 | 05 |
| Street Address |
2801 WALTER GARRETT LANE |
| City | OAK GROVE |
| State | KY |
| Zip Code | 42262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023381969 | Jennifer Jean Johnson | Nurse Practitioner | 1654 Hugh Hunter Rd #20, Oak Grove, KY 42262 | 2012-02-22 |
| 1053602367 | Jabez Empowerment, LLC | In Home Supportive Care | 175 Stateline Road, Suite 4, Oak Grove, KY 42262 | 2011-04-21 |
| 1598105488 | Randi Arlene Carr | Developmental Therapist | 304 Wilson Dr, Oak Grove, KY 42262-4210 | 2013-06-25 |
| 1780714956 | Maleka Monique Holmes | Social Worker | 180 Mandarin Dr, Oak Grove, KY 42262-7215 | 2007-03-06 |
| 1720454507 | Pennyroyal Healthcare Services, Inc. | Clinic/Center | 244 Thompsonville Ln, Oak Grove, KY 42262-8250 | 2015-08-17 |
| 1699129486 | Akeisha Danielle Peek | Developmental Therapist | 503 Gainey Dr, Oak Grove, KY 42262-8259 | 2016-04-18 |
| 1366859803 | Air Affiliates, Inc. | Durable Medical Equipment & Medical Supplies | 175 Stateline Rd Ste R-4, Oak Grove, KY 42262-8288 | 2014-07-16 |
| 1538482773 | Eddie A Manley | Nurse Practitioner | 175 Stateline Rd, Oak Grove, KY 42262-8288 | 2010-03-02 |
| 1902189541 | Priority Care Associates | Nurse Practitioner | 175 Stateline Rd, Oak Grove, KY 42262-8288 | 2011-09-20 |
| 1891712139 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 14800 Fort Campbell Blvd, Oak Grove, KY 42262-8304 | 2006-07-16 |
| Find all providers in zip 42262 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386205961 | Laura Badami | Nurse Practitioner | 10418 S Outer Belt Rd, Oak Grove, MO 64075-9085 | 2019-06-25 |
| 1457731309 | Keri Sutter | Nurse Practitioner | 2201 Se Austin St, Oak Grove, MO 64075-9255 | 2015-06-05 |
| 1023381969 | Jennifer Jean Johnson | Nurse Practitioner | 1654 Hugh Hunter Rd #20, Oak Grove, KY 42262 | 2012-02-22 |
| 1922104447 | Elaine K Akin | Nurse Practitioner | 1900 S Broadway, Box 670, Oak Grove, MO 64075 | 2006-09-15 |
| 1649376161 | Joyce E Peterson | Nurse Practitioner | 1900 S Broadway, Box 670, Oak Grove, MO 64075 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518661 | Kimberly Sue Moore | Nurse Practitioner | 1196 Sardis Rd, Mount Olivet, KY 41064-7580 | 2020-11-02 |
| 1740880640 | Kristie Lynn Hale | Nurse Practitioner | 521 East Cumberland Gap Parkway, Suite 1, Corbin, KY 40701 | 2020-10-29 |
| 1053911065 | Ashley Renee Smith | Nurse Practitioner | 8367 Stonelick Rd, Maysville, KY 41056-9432 | 2020-10-28 |
| 1629677117 | Shelby A Rollings | Nurse Practitioner | 100 Clint Hill Blvd, Paducah, KY 42001-6771 | 2020-10-26 |
| 1023618535 | Pamela Nicole Kinney | Nurse Practitioner | 13503 Terrace Creek Dr Apt 203, Louisville, KY 40245-5838 | 2020-10-26 |
| 1710586466 | Jamie Rae Ratcliff | Nurse Practitioner | 141 Ky Route 1428, Prestonsburg, KY 41653-1506 | 2020-10-23 |
| 1518566371 | Kelly Rae Smith | Nurse Practitioner | 13402 Creekview Rd, Prospect, KY 40059-9028 | 2020-10-22 |
| 1952900870 | Sarah Elizabeth Clark | Nurse Practitioner | 1309 Morning Side Ct, Lexington, KY 40509-2353 | 2020-10-21 |
| 1942809033 | Lauren Elizabeth Tobler | Nurse Practitioner | 32 Burdsall Ave, Fort Mitchell, KY 41017-2802 | 2020-10-20 |
| 1629677745 | Lisa Elaine Coleman | Nurse Practitioner | 2241 Gulfstream Dr, Lexington, KY 40504-3273 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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| 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.