Individual provider Active NPI

Lauren Olivia Rider, NP-C

  • Nurse Practitioner
  • Jefferson, GA
National Provider Identifier
1295383198
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
239315 Issued in GA
Practice address
1057 Winder Hwy
Jefferson, GA 30549-6314
Phone
(706) 708-2277
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 239315 GA Primary

Addresses

Primary practice location

1057 Winder Hwy
Jefferson, GA 30549-6314

Mailing address

390 Spinner Dr
Jefferson, GA 30549-6756
Phone (678) 977-4429

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

LicenseStateTypeSpecialty
239315GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flint Health Enhancements, LLC CurrentSince Nov 10, 2024 Accepting new patients
Commerce Spinal Center,P.C. PastSince Nov 10, 2024 Accepting new patients
Gwinnett Center Medical Associates PastSince Oct 19, 2019 Accepting new patients

Locations

1057 Winder Hwy
Jefferson, GA 30549
Phone (706) 387-0305

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEFEAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1295383198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 SPINNER DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305496756",
            "telephone_number": "678-977-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 WINDER HWY",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305496314",
            "telephone_number": "706-708-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "LAUREN",
        "middle_name": "OLIVIA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "239315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.