Alex Ryder, MD, PHD

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

53551 Issued in TN

Practice address

1280 Stateline Rd E
Southaven, MS 38671-9486

Phone

(877) 334-0021

NPI assigned

Apr 20, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Spectra Laboratories Inc

  • Clinical Medical Laboratory
  • Southaven, MS
  • NPI 1396321022
  NPD Authorized official

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688169600000",
    "number": "1033435706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 TELLURIDE CV",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381388400",
            "telephone_number": "503-559-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 STATELINE RD E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719486",
            "telephone_number": "877-334-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "ALEX",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-20",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "TN",
            "license": "53551",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CT",
            "license": "53005",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "TN",
            "license": "53551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Rucker, PHARMD
• Spencer Rushing, DO
• Jason Russell
• Kaitlin Alexander Ryan, DPT
• Robert Lawrence Ryan, CRNA
• Akhil Kumar NV Sadhu, MD
• Nouraan Sadiq
• Omar Saeed, MD
• Rosanna B Sagely, FNP
• Salt and Light Counseling LLC

• Clinical Pathology/Laboratory Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Clinical Pathology/Laboratory Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.