Active NPI
Rod R Ryder, LPC
- Professional Counselor
- Greenville, TX
National Provider Identifier
1164580684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 13039
- Practice address
- 4200 Stuart St
Greenville, TX 75401-5759 - Phone
- (903) 454-0300
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 13039 | TX | Primary |
Addresses
Primary practice location
4200 Stuart St
Greenville, TX 75401-5759
Mailing address
400 Airport Rd
PO Box
Terrell, TX 75160-4302
Phone (972) 524-4159
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13039 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1164580684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 AIRPORT RD",
"address_2": "PO BOX",
"city": "TERRELL",
"state": "TX",
"postal_code": "751604302",
"telephone_number": "972-524-4159",
"fax_number": "972-563-5321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 STUART ST",
"city": "GREENVILLE",
"state": "TX",
"postal_code": "754015759",
"telephone_number": "903-454-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYDER",
"first_name": "ROD",
"middle_name": "R",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "13039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.