Individual provider Active NPI

Ann Parker Rydman

  • Nurse Practitioner
  • Clovis, NM
National Provider Identifier
1205560810
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
69172 Issued in NM
Practice address
203 Safari Loop
Clovis, NM 88101-8798
Phone
(850) 382-4658
NPI assigned
Jul 11, 2022
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 69172 NM Primary
Critical Care Medicine Registered Nurse 163WC0200X 9436440 FL

Addresses

Primary practice location

203 Safari Loop
Clovis, NM 88101-8798

Mailing address

203 Safari Loop
Clovis, NM 88101-8798
Phone (850) 382-4658

Other names 1

  • Ann Rene Parker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221111001830 NM Practitioner - Nurse Practitioner 2466829973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.35 of 100Reported as group
Quality
80.04
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9436440FLMDCritical Care Medicine Registered Nurse
69172NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curry Emergency Group LLC Nurse Practitioner CurrentSince Nov 1, 2022 Accepting new patients
Fedko Emergency Physicians New Mexico LLC CurrentSince Feb 1, 2024 Accepting new patients
Michael a Rowley MD PA Past Accepting new patients

Locations

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

42121 US Highway 70
Portales, NM 88130
Phone (505) 226-3627

Organizations & group practices 3

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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1205560810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 SAFARI LOOP",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881018798",
            "telephone_number": "850-382-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 SAFARI LOOP",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881018798",
            "telephone_number": "850-382-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDMAN",
        "first_name": "ANN",
        "middle_name": "PARKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "69172",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "9436440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "PARKER",
            "middle_name": "RENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.