SHANE THOMAS RIDGE (NPI# 1780884569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780884569 |
| Entity Type | Individual |
| Full Name | SHANE THOMAS RIDGE |
| Credential | D.O. |
| Practice Address |
250 Flat Rock Pl 2nd Fl Westbrook CT 06498-1565 |
| Mailing Address |
28 Crescent St Middletown CT 06457-3654 |
| Practice Telephone | 8603583640 |
| Practice Fax Number | 8603588656 |
| Mailing Telephone | 8603584820 |
| Mailing Fax Number | 8603588661 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2017-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 045427 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008024237 | 05 |
| Street Address |
250 FLAT ROCK PL 2ND FL |
| City | WESTBROOK |
| State | CT |
| Zip Code | 06498-1565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053385310 | David E Walker | Family Medicine | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2006-02-14 |
| 1033561758 | Megin Iaccarino | Nurse Practitioner | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2016-07-06 |
| 1326497876 | Jason Ziegler | Family Medicine | 250 Flat Rock Pl, Westbrook, CT 06498-3585 | 2016-06-06 |
| 1962889337 | Juliette Nedah Harris | Family Medicine | 250 Flat Rock Pl, Westbrook, CT 06498-3585 | 2015-05-05 |
| 1811246929 | Laura E. Wing | Nurse Practitioner | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2012-09-05 |
| 1487910527 | Colleen R Chappell | Physician Assistant | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2012-04-03 |
| 1114205473 | Tara T.s. Fagan | Nurse Practitioner | 250 Flat Rock Pl, Westbrook, CT 06498-1565 | 2011-08-03 |
| 1619200920 | Lauren Hart Nichols | Physician Assistant | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2009-09-18 |
| 1881705226 | Valerie M Small | Family Medicine | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699966648 | Anthony P Ciaburri | Physical Therapist | 5 Pequot Park Road, Suite 303, Westbrook, CT 06498 | 2007-08-06 |
| 1043224579 | Thomas V Brady | Dentist | 1823 Boston Post Rd, Westbrook, CT 06498 | 2006-07-28 |
| 1194760579 | Gregory J Kundrat | Family Medicine | 4 Grove Beach Rd North, Building 1, Unit A, Westbrook, CT 06498 | 2006-06-18 |
| 1437468386 | Westbrook Youth and Family Services, Inc | Counselor | 1163 Boston Post Rd, Westbrook, CT 06498-0918 | 2010-09-27 |
| 1912295924 | Marvin Lloyd Sears | Ophthalmology | 952 Pond Meadow Rd, Westbrook, CT 06498-1429 | 2011-07-12 |
| 1689841660 | Kristina J. Lipeika | Physical Therapist | 5 Pequot Park Rd, Lakebrook Medical Center Suite 303, Westbrook, CT 06498-1467 | 2008-05-09 |
| 1700321403 | Dignity Home Health LLC | Home Health | 30 Ken Rose Ter, Westbrook, CT 06498-1487 | 2017-01-04 |
| 1568551174 | Holly Finley David | Dietitian, Registered | 44 Andre Dr, Westbrook, CT 06498-1525 | 2006-10-12 |
| 1851510929 | Mhs Primary Care, Inc. | Internal Medicine | Physician Office One, 250 Flat Rock Pl, Westbrook, CT 06498-1565 | 2007-04-25 |
| 1063937860 | Middlesex Hospital | Internal Medicine | Physician Office One, 250 Flat Rock Place, Westbrook, CT 06498-1565 | 2017-08-14 |
| Find all providers in zip 06498 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568606713 | Hadjh Tobias Ahrns | Family Medicine | 1 Harnois Ave Ste 2a, Westbrook, ME 04092-4395 | 2009-04-30 |
| 1972780930 | Jeong Eun Oh | Family Medicine | 4 Grove Beach Rd N, Bldg1, Unit A, Westbrook, CT 06498-1656 | 2008-01-22 |
| 1194760579 | Gregory J Kundrat | Family Medicine | 4 Grove Beach Rd North, Building 1, Unit A, Westbrook, CT 06498 | 2006-06-18 |
| 1588621767 | Donald Francis Yorkey Jr. | Family Medicine | 5 Elmwood Ave, Westbrook, ME 04092-3716 | 2006-04-29 |
| 1750340154 | Catherine Anne Lockwood | Family Medicine | 40 Park Rd, Westbrook, ME 04092-3188 | 2006-03-23 |
| 1053385310 | David E Walker | Family Medicine | 250 Flat Rock Pl, 2nd Fl, Westbrook, CT 06498-1565 | 2006-02-14 |
| 1326497876 | Jason Ziegler | Family Medicine | 250 Flat Rock Pl, Westbrook, CT 06498-3585 | 2016-06-06 |
| 1962889337 | Juliette Nedah Harris | Family Medicine | 250 Flat Rock Pl, Westbrook, CT 06498-3585 | 2015-05-05 |
| 1518353945 | Darlene Peterson | Family Medicine | 1 Harnois Ave, Westbrook, ME 04092-4392 | 2015-04-13 |
| 1457797235 | Brigitte Salembier | Family Medicine | 1 Harnois Ave, Suite 2a, Westbrook, ME 04092-4392 | 2013-05-20 |
| Find all providers in WESTBROOK | ||||
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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.