Individual provider Active NPI

Amanda M Ryden, MD

  • Emergency Medicine Physician
  • Carbondale, IL
National Provider Identifier
1033223359
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036143926 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
Fax
(618) 457-0469
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37787 KY
Emergency Medicine Physician 207P00000X 42040 TN
Emergency Medicine Physician 207P00000X 036143926 IL Primary

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

PO Box 1467
Indianapolis, IN 46206-1467
Phone (618) 457-5200

Other practice location 1

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

Other practice location 2

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Other identifiers 2

IdentifierTypeStateIssuer
200445280MedicaidIN
64062599MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041214000271 KY Practitioner - Emergency Medicine 0840257663 Reassigns benefits to 1 organization
I20080131000382 TN Practitioner - Emergency Medicine 0840257663 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

11701 Bluegrass Pkwy
Suite 100
Louisville, KY 40299-2302
Phone (502) 928-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036143926ILMDEmergency Medicine Physician
37787KYMDEmergency Medicine Physician
42040TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jul 6, 2023 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 6, 2023 Accepting new patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Jan 15, 2023 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Mar 24, 2024 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients
Solomon Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Elizabethtown Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Medical Observation Services LLC Emergency Medicine Past Accepting new patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients
Emergency Physicians of Hopkinsville PLLC Emergency Medicine Past Accepting new patients
Tennessee Em-I Medical Services PC Past Accepting new patients
Hopkinsville Emergency Physicians LLC Emergency Medicine Past Accepting new patients
TN-I Medical Services PC Past Accepting new patients
Emergency Physicians of Montgomery County, PLLC Emergency Medicine Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Mercy Hospital South Emergency Medicine Past Accepting new patients
Ehra Medical Services of Tennessee PC Emergency Medicine Past Accepting new patients
Cane Ridge Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

11701 Bluegrass Pkwy
#100
Louisville, KY 40299
Phone (502) 928-4100

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

5150 Airline Rd
Arlington, TN 38002
Phone (865) 985-7047

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

391 Wallace Rd
Nashville, TN 37211
Phone (615) 332-6253

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

520 W Main St
Smithville, TN 37166
Phone (615) 215-5000

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 18

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033223359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1467",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061467",
            "telephone_number": "618-457-5200",
            "fax_number": "618-529-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721",
            "fax_number": "618-457-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "fax_number": "618-988-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYDEN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "37787",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "42040",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036143926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200445280",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64062599",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.