JOHN CHARLES RIDDELL (NPI# 1780958132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780958132 |
| Entity Type | Individual |
| Full Name | JOHN CHARLES RIDDELL |
| Credential | CADC I |
| Practice Address |
2035 Davcor St Se Salem OR 97302-1595 |
| Mailing Address |
1575 19th St Ne Salem OR 97301-7931 |
| Practice Telephone | 5035764660 |
| Practice Fax Number | 5033612688 |
| Mailing Telephone | 5035856255 |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2012-03-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174593073 | John M Riddell | Anesthesiology | 1 Medical Center Dr, Dhmc Department of Anesthesiology, Lebanon, NH 03756-1000 | 2006-01-24 |
| Street Address |
2035 DAVCOR ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619031077 | Vicki Jean Tournay | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2006-12-20 |
| 1295234748 | Richard Narvaez | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2018-02-09 |
| 1215443700 | Pamela Jones | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-12-19 |
| 1366961245 | David Arley Mintken | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-09-12 |
| 1902324486 | Krystal Gail Roloff | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-09-05 |
| 1811436587 | Ashley Marie Anastasio | Licensed Practical Nurse | 2035 Davcor St Se, Salem, OR 97302-1595 | 2017-02-15 |
| 1811447808 | Alexandria Mary Kolody | Licensed Practical Nurse | 2035 Davcor St Se, Salem, OR 97302-1595 | 2016-10-13 |
| 1720456171 | Charles Edward Johnson | Counselor | 2035 Davcor St Se, Salem, OR 97302-1595 | 2015-09-02 |
| 1457747578 | Mary Courser | Registered Nurse | 2035 Davcor St Se, Salem, OR 97302-1595 | 2015-04-15 |
| 1073917316 | Anthony Sparzo | Counselor | 2035 Davcor St Se, Salem, OR 97302 | 2014-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978880 | Deirdre Jean Miller | Counselor | 1101 N Jim Day Rd Ste 109, Salem, IN 47167-5201 | 2020-10-01 |
| 1134736168 | Melissa Thi Lu | Counselor | 2045 Silverton Rd Ne Ste 2100, Salem, OR 97301-0100 | 2020-09-24 |
| 1841805959 | Korben J Chesnut-petry | Counselor | 1325 Commercial St Se, Salem, OR 97302-4205 | 2020-09-15 |
| 1598383846 | Jorge Montejano | Counselor | 223 Commercial St Ne, Salem, OR 97301-3411 | 2020-07-13 |
| 1154956837 | Bobbie J Dawson | Counselor | 215 Barrs Ln, C/o Dawson, Salem, WV 26426-6224 | 2020-03-03 |
| 1902457773 | Jorge Arredondo | Counselor | 16 Heritage Dr Apt 15, Salem, MA 01970-2034 | 2019-09-24 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659866911 | Chakra LLC | Counselor | 161 High St Se Ste 209, Salem, OR 97301-3693 | 2018-06-28 |
| 1346731114 | Robert Bathke | Counselor | 525 Ferry St Se Ste 203, Salem, OR 97301-3743 | 2018-05-28 |
| 1316453186 | Melody Sue Nova | Counselor | 2045 Silverton Rd Ne Ste A, Salem, OR 97301-0100 | 2017-12-15 |
| Find all providers in SALEM | ||||
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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.