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LESLIE RIDDLE
NPI 1639750169
Nurse Practitioner - Family in Provo, UT

Active since April 16, 2021PECOS Enrolled
1231 CAMELOT DR, PROVO, UT 84601(801) 691-9875 Get Directions Write a Review

NPPES record last updated: December 29, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 18, 2022, Apr 16, 2021 (2 updates tracked since 2021).

About Leslie Riddle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LESLIE RIDDLE (NPI 1639750169) is an individual family provider in Provo, Utah, licensed in Utah (277694-4405) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1639750169
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameLESLIE RIDDLE
Location Address1231 CAMELOT DRProvo, UT 84601-1454
Mailing Address1840 S 1300 ESalt Lake City, UT 84105-3617
Phone(801) 691-9875
Sole ProprietorNo
Enumeration DateApril 16, 2021
Last NPPES UpdateDecember 29, 20232 updates tracked since enumeration
NPPES CertifiedDecember 29, 2023
✔ NPI 1639750169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 277694-4405
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1231 CAMELOT DR, Provo, UT 84601
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Secondary Practice Location 1

Location 11840 S 1300 ESalt Lake City, UT 84105-3617 · Phone (801) 832-2200

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Leslie Riddle is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leslie Riddle's NPI number?

The NPI number for Leslie Riddle is 1639750169. It was assigned to this individual provider in the NPPES registry on April 16, 2021.

Where is Leslie Riddle located?

Leslie Riddle practices at 1231 Camelot Dr, Provo, UT 84601. The listed phone number is (801) 691-9875.

What is Leslie Riddle's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Leslie Riddle enrolled in Medicare?

Yes. Leslie Riddle is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leslie Riddle was last updated on December 29, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.