Organization Active NPI

Lehigh Valley Physician Group

  • Family Medicine Physician
  • Schnecksville, PA
National Provider Identifier
1003050790
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEHIGH VALLEY PHYSICIAN GROUP
Practice address
4955 Route 873
Suite B
Schnecksville, PA 18078-2268
Phone
(610) 799-4100
NPI assigned
Apr 24, 2009
Organization subpart
Yes
Parent organization
LEHIGH VALLEY PHYSICIAN GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Callahan
Title
Associate Exec Director of Finance
Phone
(610) 798-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4955 Route 873
Suite B
Schnecksville, PA 18078-2268

Mailing address

1605 N Cedar Crest Blvd
Suite 110B
Allentown, PA 18104-2351

Other names 1

  • Kenneth G. Ryder, MD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000335 PA Part B Supplier - Clinic/Group Practice 3072425123 Receives reassigned benefits from 3,502 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0934564Kenneth G Ryder MD4955 Route 873 Suite B, Schnecksville, PA 18078Provider-performed microscopyOct 7, 2027

National Provider Directory

National Provider Directory
Part of
LVPG Psychiatry

Locations

2400 Chew St
Fl 2
Allentown, PA 18104

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1003050790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD",
            "address_2": "SUITE 110B",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 ROUTE 873",
            "address_2": "SUITE B",
            "city": "SCHNECKSVILLE",
            "state": "PA",
            "postal_code": "180782268",
            "telephone_number": "610-799-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEHIGH VALLEY PHYSICIAN GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEHIGH VALLEY PHYSICIAN GROUP",
        "enumeration_date": "2009-04-24",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSOCIATE EXEC DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "610-798-4500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth G. Ryder, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Schnecksville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.