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

Mr. Jerry Rider, PA-C

Individual provider Physician Assistant · NPI 1194884494

Mr. Jerry Rider, PA-C is a Physician Assistant in Fort Carson, Colorado. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1650 Cochrane Cir
Fort Carson, CO 80913-4613
Phone: (719) 526-2361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2594 (TN)
Physician Assistant Taxonomy 363A00000X
Surgical Physician Assistant Taxonomy 363AS0400X
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 2594 (TN)

Record details

NPI number1194884494
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 6, 2006
Last updated in NPPESJune 13, 2024
Certification dateJune 5, 2024

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