Individual provider Active NPI

Nicholas Ryder, CPC

  • Peer Specialist
  • Tacoma, WA
National Provider Identifier
1023636024
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
3901 South Fife Street
Suite 301
Tacoma, WA 98409
Phone
(253) 589-5334
Fax
(253) 584-1496
NPI assigned
Jul 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X WA Primary

Addresses

Primary practice location

3901 South Fife Street
Suite 301
Tacoma, WA 98409

Mailing address

3901 South Fife Street
Suite 301
Tacoma, WA 98409
Phone (253) 589-5334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1023636024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 SOUTH FIFE STREET",
            "address_2": "SUITE 301",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98409",
            "telephone_number": "253-589-5334",
            "fax_number": "253-584-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 SOUTH FIFE STREET",
            "address_2": "SUITE 301",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98409",
            "telephone_number": "253-589-5334",
            "fax_number": "253-584-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "NICHOLAS",
        "credential": "CPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.