NPIMap

Individual provider Active NPI

Ardith A Ryberg, MD

  • Surgery Physician
  • Council Bluffs, IA
National Provider Identifier
1174631261
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
19489 Issued in NE
Practice address
801 Harmony St
Suite 408
Council Bluffs, IA 51503-3106
Phone
(712) 256-6160
Fax
(402) 895-5060
NPI assigned
Aug 28, 2006
Last updated
Aug 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 19489 NE Primary

Addresses

Primary practice location

801 Harmony St
Suite 408
Council Bluffs, IA 51503-3106

Mailing address

1112 S 113TH CT
Omaha, NE 68144-1857
Phone (402) 334-9171

Other identifiers 4

IdentifierTypeStateIssuer
209767946MedicaidMO
32328OtherNEBLUE CROSS BLUE SHIELD
10025492800MedicaidNE
3507293MedicaidIA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19489NEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Gastrointestinal Associates PC Past Accepting new patients
Boone County Hospital Past Accepting new patients
Alegent Creighton Clinic Past Accepting new patients
Omaha Surgical Consultants PC Surgery Past Accepting new patients
Infectious Disease & Epidemiology Associates PC Past Accepting new patients
Midwest Urology Associates, P.C. Past Accepting new patients
Surgical Services of the Great Plains PC Surgery Past Accepting new patients

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1174631261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 S 113TH CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681441857",
            "telephone_number": "402-334-9171",
            "fax_number": "402-895-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HARMONY ST",
            "address_2": "SUITE 408",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033106",
            "telephone_number": "712-256-6160",
            "fax_number": "402-895-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYBERG",
        "first_name": "ARDITH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "19489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209767946",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "32328",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025492800",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3507293",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.