STEPHANIE MICHELLE RIDDELL – Family Nurse Practitioner, NPI 1174149066

STEPHANIE MICHELLE RIDDELL is a healthcare provider. based in Salt lake city, Utah. specializing in NURSE PRACTITIONER. They hold a License No. APN.0995511-NP (CO). The NPI Number for STEPHANIE MICHELLE RIDDELL is 1174149066

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE MICHELLE RIDDELL
NPI
1174149066
Phone
(801) 266-3113
Address
6405 S 3000 E STE 300
Enumeration Date
17 June 2020
Last Update Date
5 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9709039853
Graduation Year
2020 (6 years ago)
PAC ID
0042685885
Group Practice PAC ID
8426362450
Professional Enrollment ID
I20230410002501
Address ID
CO813015708DU270XXAVEX414
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

5,198 NURSE PRACTITIONER in CO

Provider Addresses for STEPHANIE MICHELLE RIDDELL

  • 6405 S 3000 E STE 300

    SALT LAKE CITY, UT 841216977

    Phone: (801) 266-3113

    Fax: (801) 266-5633

    Type: Mailing

  • 2095 N DOLORES RD

    CORTEZ, CO 813218924

    Phone: (970) 564-8086

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $170.

Total Amount is formed as General ($170) + Research ($0) + Ownership ($0) = $170.

Last reported payment date: 2024-02-07 • Largest payer in this snapshot: ABBVIE INC. ($100).

Total Amount

$170

General + Research + Ownership

Payments

9

Total payment records

General Amount

$170

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-04-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20230410002501INurse PractitionerCOTBD
I20250416001424INurse PractitionerUTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes19695$0
36415Insertion of needle into vein for collection of blood sample11481$0
99214Established patient office or other outpatient visit, 30-39 minutes8257$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3838$0
83036Hemoglobin a1c level2821$0
View full utilization report →

Insurance plans in this area (ZIP 84121)

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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: 8426362450View full group profile
NameSpecialtyState
Nurse PractitionerCO
Nurse PractitionerUT
Nurse PractitionerNM
Family PracticeNM
P O D I A T R YNM
Family Practice, Pediatric MedicineUT
Nurse PractitionerNM
Nurse PractitionerUT
Nurse PractitionerNM
P O D I A T R YUT

Reviews

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Frequently asked questions

Can I cross-check STEPHANIE MICHELLE RIDDELL using NPI 1174149066?
NPI 1174149066 belongs to STEPHANIE MICHELLE RIDDELL; compare other details if you need extra assurance.
Is STEPHANIE MICHELLE RIDDELL still an active registrant?
STEPHANIE MICHELLE RIDDELL carries an active NPI according to the public dataset.
What expertise is attributed to STEPHANIE MICHELLE RIDDELL?
STEPHANIE MICHELLE RIDDELL's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is STEPHANIE MICHELLE RIDDELL associated with Salt Lake City?
Public fields place STEPHANIE MICHELLE RIDDELL around Salt Lake City, Utah. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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