Individual provider Active NPI

Sally Elaine Ryden, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Gainesville, FL
National Provider Identifier
1295760254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME29117 Issued in FL
Practice address
6500 W Newberry Rd
Gainesville, FL 32605-4309
Phone
(352) 333-3495
Fax
(352) 333-4284
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME29117 FL Primary

Addresses

Primary practice location

6500 W Newberry Rd
Gainesville, FL 32605-4309

Mailing address

PO Box 147050
PMB 509
Gainesville, FL 32614-7050
Phone (352) 375-0166

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME29117FLMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295760254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147050",
            "address_2": "PMB 509",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326147050",
            "telephone_number": "352-375-0166",
            "fax_number": "352-375-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054309",
            "telephone_number": "352-333-3495",
            "fax_number": "352-333-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDEN",
        "first_name": "SALLY",
        "middle_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME29117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.