| Jeffrey Dean Ridge, FNP-C | |
|
116 W Minnesota Avenue, Mccloud, CA 96057 | |
| (530) 964-2389 | |
| (530) 964-3141 |
| Full Name | Jeffrey Dean Ridge |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 116 W Minnesota Avenue, Mccloud, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083180533 | NPI | - | NPPES |
| 1083180533 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP139196 (Texas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 95011517 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Medical Center Of Mt Shasta | Mount shasta, CA | Hospital |
| Fairchild Medical Center | Yreka, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mccloud Healthcare Clinic, Inc. | 3779494919 | 7 |
| Entity Name | Mccloud Healthcare Clinic, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164428488 PECOS PAC ID: 3779494919 Enrollment ID: O20031118001091 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Dean Ridge, FNP-C 116 W Minnesota Avenue, Mccloud, CA 96057 Ph: (530) 964-2389 | Jeffrey Dean Ridge, FNP-C 116 W Minnesota Avenue, Mccloud, CA 96057 Ph: (530) 964-2389 |
Susan Renae Berliner, FNP, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 116 W. Minnesota Ave., Mccloud, CA 96057 Phone: 530-964-2389 | |
Dr. Megan Hoy, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 116 W. Minnesota Ave., Mccloud, CA 96057 Phone: 530-964-2389 | |
Denise Lewis, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 116 W Minnesota Ave, Mccloud, CA 96057 Phone: 530-964-2389 |