Provider Demographics
NPI:1871571224
Name:RIPPERGER, RICHARD R (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:RIPPERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27005 GLYNNS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-9405
Mailing Address - Country:US
Mailing Address - Phone:563-320-4756
Mailing Address - Fax:
Practice Address - Street 1:27005 GLYNNS CREEK CT
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748
Practice Address - Country:US
Practice Address - Phone:563-320-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2018-07-11
Deactivation Date:2018-05-24
Deactivation Code:
Reactivation Date:2018-07-10
Provider Licenses
StateLicense IDTaxonomies
IAMD-20699207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA57860OtherWELLMARK
IA58100OtherWELLMARK
038967OtherHEALTH ALLIANCE
19816OtherIA HEALTH SOLUTIONS
IA0192724Medicaid
IL8121085OtherBCBS
IAIA0141OtherJOHN DEERE FAMILY
1602940OtherFIRST HEALTH
200029098OtherRR MEDICARE
IAT80524OtherJOHN DEERE FAMILY
15606OtherMIDLANDS CHOICE
1602940OtherFIRST HEALTH
IL8121085OtherBCBS