Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin W Riddleberger, PA

Individual provider Surgical Physician Assistant · NPI 1396745683

Kevin W Riddleberger, PA is a Surgical Physician Assistant in Longmont, Colorado. Licensed in Colorado. Registered with an NPI since 2005.

Licensed in
CO
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1551 Professional Ln Ste 200
Longmont, CO 80501-6972
Phone: (303) 772-1600
Fax: (303) 772-9317
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1801 (CO)
Physician Assistant Taxonomy 363A00000X · Licence 1801 (CO)

Record details

NPI number1396745683
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 28, 2005
Last updated in NPPESNovember 9, 2010

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