Individual provider Active NPI

Mary Teresa Ryder, M.D.

  • Family Medicine Physician
  • Lorton, VA
National Provider Identifier
1437189982
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101052496 Issued in VA
Practice address
9500 Richmond Hwy
Lorton, VA 22079-2124
Phone
(703) 339-7788
Fax
(703) 339-5713
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101052496 VA Primary

Addresses

Primary practice location

9500 Richmond Hwy
Lorton, VA 22079-2124

Mailing address

5780 Westchester St
Alexandria, VA 22310-1145
Phone (703) 719-0461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915000225 PA Order and Referring Only - Family PracticePractitioner - Family Practice 1355637554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101052496VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1437189982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 WESTCHESTER ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223101145",
            "telephone_number": "703-719-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 RICHMOND HWY",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220792124",
            "telephone_number": "703-339-7788",
            "fax_number": "703-339-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "MARY",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101052496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorton, VA

Sources for this page

Verify at the official NPI Registry.