Individual provider Active NPI

Andrew Rider

  • Clinical Social Worker
  • Anderson, IN
National Provider Identifier
1285178988
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007656A Issued in IN
Practice address
1601 Medical Arts Blvd
Ste 203
Anderson, IN 46011-3458
Phone
(317) 621-5719
NPI assigned
Dec 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34007656A IN Primary

Addresses

Primary practice location

1601 Medical Arts Blvd
Ste 203
Anderson, IN 46011-3458

Mailing address

6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805

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

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1285178988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MEDICAL ARTS BLVD",
            "address_2": "STE 203",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113458",
            "telephone_number": "317-621-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-14",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007656A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.