Active NPI
Danelle Ryder, CNA
- Nurse's Aide
- Decatur, GA
National Provider Identifier
1356014666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CN0028867093
- Practice address
- 3483 Kingswood Run
Decatur, GA 30034-4839 - Phone
- (678) 830-9457
- NPI assigned
- Aug 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CN0028867093 | GA | Primary |
Addresses
Primary practice location
3483 Kingswood Run
Decatur, GA 30034-4839
Mailing address
3483 Kingswood Run
Decatur, GA 30034-4839
Phone (678) 830-9457
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20052007 | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CN0028867093 | GA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627776000000",
"number": "1356014666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3483 KINGSWOOD RUN",
"city": "DECATUR",
"state": "GA",
"postal_code": "300344839",
"telephone_number": "678-830-9457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3483 KINGSWOOD RUN",
"city": "DECATUR",
"state": "GA",
"postal_code": "300344839",
"telephone_number": "678-830-9457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYDER",
"first_name": "DANELLE",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-01",
"last_updated": "2021-08-01",
"certification_date": "2021-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "GA",
"license": "CN0028867093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20052007",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.