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JENNIFER RIDENOURE P.A.C
NPI 1912012816
Physician Assistant - Medical in Fort Lauderdale, FL

Active since August 20, 2006PECOS Enrolled
1330 RIVERLAND RD, FORT LAUDERDALE, FL 33312(954) 321-9826(954) 321-9660 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jennifer Ridenoure P.a.c NPPES

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

JENNIFER RIDENOURE P.A.C (NPI 1912012816) is an individual medical provider in Fort Lauderdale, Florida, licensed in Florida (PA9103460) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912012816
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJENNIFER RIDENOURECredential: P.A.C
Location Address1330 RIVERLAND RDFort Lauderdale, FL 33312-2961
Mailing Address2936 Cambridge LnHollywood, FL 33026-3748 · (954) 704-0108
Phone(954) 321-9826
Fax(954) 321-9660
Sole ProprietorNo
Enumeration DateAugust 20, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1912012816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in FL · PA9103460
1330 RIVERLAND RD, Fort Lauderdale, FL 33312
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Other Identifiers 1

Medicare ID-Type UnspecifiedU6362ZFL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Ridenoure P.a.c 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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANGELA MARIA RODRIGUEZ MD
Family Medicine
1330 RIVERLAND RD
FORT LAUDERDALE, FL 33312
Broward County (954) 321-9826
BROWARD MEDICAL CENTER OF DAVIE INC
Family Medicine
1330 RIVERLAND RD
FORT LAUDERDALE, FL 33312
Broward County (954) 321-9826
VERONICA O'CONNOR
Physician Assistant (Medical)
1330 RIVERLAND RD
FT LAUDERDALE, FL 33312
Broward County (954) 321-9826
VANGUARD MEDICAL GROUP LLC
Family Medicine
1330 RIVERLAND RD
FORT LAUDERDALE, FL 33312
Broward County (954) 321-9826

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 Jennifer Ridenoure's NPI number?

The NPI number for Jennifer Ridenoure is 1912012816. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Where is Jennifer Ridenoure located?

Jennifer Ridenoure practices at 1330 Riverland Rd, Fort Lauderdale, FL 33312. The listed phone number is (954) 321-9826.

What is Jennifer Ridenoure's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jennifer Ridenoure enrolled in Medicare?

Yes. Jennifer Ridenoure is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jennifer Ridenoure was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.