Mr Jerry Rider, PA-C is a
Physician Assistant - Surgical based in Air Force Academy, Colorado. Mr Jerry Rider is licensed to practice in Tennessee (license number 2594) and his current practice location is
10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, Colorado. He can be reached at his office (for appointments etc.) via phone at
(719) 684-3159.
NPI number for Mr Jerry Rider is 1194884494 and his current mailing address is 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1194884494.
Provider's Profile
Full Name | Mr Jerry Rider |
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Gender | Male |
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Speciality | Physician Assistant - Surgical |
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Location | 10th Medical Group/sghc, Air Force Academy, Colorado |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1194884494
- Provider Enumeration Date: 12/06/2006
- Last Update Date: 03/20/2023
Medical Identifiers
Medical identifiers for Mr Jerry Rider such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194884494 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AS0400X | Physician Assistant - Surgical | (* (Not Available)) | Secondary |
363AS0400X | Physician Assistant - Surgical | 2594 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jerry Rider is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Jerry Rider, PA-C 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, CO 80840 Ph: (719) 684-3159 | Mr Jerry Rider, PA-C 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, CO 80840 Ph: (719) 684-3159 |
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