Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1447708979 Individual Practitioner Male Practitioner

Gregory Ridenour

Nurse Practitioner - Neonatal • Fort Wayne, IN

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Gregory Ridenour is a registered Nurse Practitioner - Neonatal practitioner in Fort Wayne, IN. With approximately 10 years of clinical practice since completing medical education in 2016, Gregory Ridenour provides healthcare services at the registered practice location at 7950 W JEFFERSON BLVD.

Gregory Ridenour does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

7950 W Jefferson Blvd

Fort Wayne, IN 468044140

Telephone 2604357001
Associated Practice Facility / Clinic
🏢 Iom Health System Lp Facility NPI 1306897335

Medicare Profile & Education

Medical School

Other

Graduation Year

2016

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Neonatal in Fort Wayne, IN

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
10 Yrs +2.0 yrs vs City Avg
City Avg: 8.0 Yrs
State Avg: 9.5 Yrs
Regional Practice Density
4 Specialists

Practicing in Fort Wayne, IN (160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ridenour (10 Years) 10 Yrs
Fort Wayne Specialty Average (8.0 Years) 8.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-04-25
Nurse Practitioner - Neonatal Primary Specialty

NUCC Taxonomy Code: 363LN0000X

State License OH APRN.CNP.019874

Definition to come...

Nurse Practitioner - Neonatal, Critical Care

NUCC Taxonomy Code: 363LN0005X

State License OH APRN.CNP.019874

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0265386 (OH)

Secondary Practice Locations

700 Childrens Dr

Columbus, OH 432052664

Phone: 6147226216

11115 Parkview Plaza Dr

Fort Wayne, IN 468451701

Phone: 2606726443

111 S Grant Ave

Columbus, OH 432154701

Phone: 6145669000

5100 W Broad St

Columbus, OH 432281607

Phone: 6147224560

1010 Refugee Rd

Pickerington, OH 431479653

Phone: 6147224560

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Anuradha Bommakanti , MD

Internal Medicine - Pulmonary Disease

NPI 1003265455

Doctor of Medicine (M.D.)

Dr. Vaneska Bottino Da Costa , MD

Pediatrics - Pediatric Critical Care Medicine

NPI 1003292525

Doctor of Medicine (M.D.)

Jacqueline Shepard

Physician Assistant

NPI 1003686908
Dr. Bruce Sowers , MD

Emergency Medicine

NPI 1053411413

Doctor of Medicine (M.D.)

Ethyn Dust

Physician Assistant

NPI 1073499620
Dr. Jyotshal Ghimire , DO

Internal Medicine

NPI 1083316814

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2025

Nurse Practitioner (License #APRN.CNP.019874 in OH)

📍
Updated Practice Location October 14, 2020

Registered at 7950 W JEFFERSON BLVD, FORT WAYNE, IN 468044140 (Tel: 2604357001)

📍
Updated Business Mailing Address October 14, 2020

Registered at 6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 468047934 (Tel: 2604793516)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 14, 2020

Nurse Practitioner (License #28194228A in IN)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Nurse Practitioner (License #RN.429014 in OH)

NPI Profile Active February 13, 2018

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address February 13, 2018

Registered at 3702 NEW VISION DR BLDG B, FORT WAYNE, IN 468451703 (Tel: 2602666013)

📍
Updated Practice Location February 13, 2018

Registered at 700 CHILDRENS DR, COLUMBUS, OH 432052664 (Tel: 6147226216)

👤
Provider Name / Credentials Updated February 13, 2018

Recorded as GREGORY RIDENOUR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2018

Nurse Practitioner (License #28194228A in IN)

NPI Profile Active September 13, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 13, 2016

Registered at 700 CHILDRENS DR, COLUMBUS, OH 432052664 (Tel: 6147226216)

📍
Updated Business Mailing Address September 13, 2016

Registered at 700 CHILDRENS DR, COLUMBUS, OH 432052664 (Tel: 6147226216)

👤
Provider Name / Credentials Updated September 13, 2016

Recorded as GREGORY RIDENOUR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2016

Nurse Practitioner (License #RN.429014 in OH)

🟢
Initial NPI Registration & Enumeration September 13, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1447708979
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 13, 2016
Last Update: April 25, 2025
Sole Proprietor: No

Mailing Address

6920 Pointe Inverness Way Ste 200

Fort Wayne, IN 468047934

Phone: 2604793516

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.