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

Mary Victoria Riddle

Individual provider Physician Assistant · NPI 1710556352

Mary Victoria Riddle is a Physician Assistant in Richmond, Virginia. Qualified in 2021, 5 years ago. Practices with Southeastern Intensivist Services PC, a 237-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
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Practice location Address checks out

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone: (804) 483-0000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1401 Johnston Willis Dr, North Chesterfield, VA 23235-4730 — (804) 483-0000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1710556352
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 18, 2021
Last updated in NPPESJuly 28, 2026
Certification dateJuly 28, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Southeastern Intensivist Services Pc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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