KYLA RENEE RIDDELL (APRN) – Family Nurse Practitioner, NPI 1043090400

KYLA RENEE RIDDELL (APRN) is a healthcare provider. based in Covington, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 4010006 (KY). The NPI Number for KYLA RENEE RIDDELL (APRN) is 1043090400

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KYLA RENEE RIDDELL (APRN)
NPI
1043090400
Phone
(859) 655-6100
Address
1401 MADISON AVE
Enumeration Date
3 October 2023
Last Update Date
3 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8596556100
Graduation Year
2023 (3 years ago)
PAC ID
8527413160
Group Practice PAC ID
9638089642
Professional Enrollment ID
I20231017001443
Address ID
KY410711352NE30XXXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

7,343 NURSE PRACTITIONER in KY

Provider Addresses for KYLA RENEE RIDDELL (APRN)

  • 1401 MADISON AVE

    COVINGTON, KY 410113313

    Phone: (859) 655-6100

    Fax: (859) 655-6179

    Type: Location

  • 215 E 11TH ST

    NEWPORT, KY 410712203

    Phone: (859) 655-6100

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231017001443INurse PractitionerKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 41011)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638089642View full group profile
NameSpecialtyState
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
O B S T E T R I C S/ G Y N E C O L O G YOH
Family Practice, Geriatric MedicineMO
Nurse PractitionerOH
-KY
Family PracticeKY
Family PracticeKY
Mental Health CounselorKY

Reviews

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Frequently asked questions

Can I verify KYLA RENEE RIDDELL (APRN) with an NPI only?
You can start verification with NPI 1043090400 for KYLA RENEE RIDDELL (APRN), then check state licensing separately.
Does the file indicate KYLA RENEE RIDDELL (APRN) is practicing under active NPI?
Directory data currently reports KYLA RENEE RIDDELL (APRN) as active.
What healthcare role does KYLA RENEE RIDDELL (APRN) hold?
Scheduling teams often label KYLA RENEE RIDDELL (APRN) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does KYLA RENEE RIDDELL (APRN) list a practice location?
Patients near Covington, Kentucky may find KYLA RENEE RIDDELL (APRN) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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