Ryder Lane Costa, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

COST-GQ4B33 Issued in MS

Practice address

611 Alcorn Dr
Corinth, MS 38834-9388

Phone

(662) 293-1143

NPI assigned

Jun 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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.

Specialty

Internal Medicine

Education

Alabama College of Osteopathic Medicine, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Helen Keller Hospital Hospital, Sheffield, AL, CCN 010019
• Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445
  Care Compare affiliation
• HH Health System - Shoals LLC

  • General Acute Care Hospital
  • Sheffield, AL
  • NPI 1508952235
  Care Compare affiliation

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1053005751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349388",
            "telephone_number": "662-293-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "RYDER",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "COST-GQ4B33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinth Surgical Clinic, P.a.
• Caitlin Bridget Corker Relph, PHARMD
• Cornerstone Health & Rehab of Corinth, LLC
• Cornerstone Rehabilitation and Healthcare Center, LLC
• Debany Corral-Ozaeta, LMSW
• Cottages Corinth, LLC
• Chelsea Cottrell
• Cox Counseling
• Sheila Crawford, R.N.
• Laura Jane Crecelius, M.D.

• Internal Medicine Physician in Corinth, MS
• Providers in Corinth, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.
• 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.