Individual provider Active NPI

Kyle Garrett Ryder

  • Acute Care Nurse Practitioner
  • Huntington, WV
National Provider Identifier
1477427268
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
124375 Issued in WV
Practice address
2828 1St Ave Ste 510
Huntington, WV 25702-1236
Phone
(304) 399-7548
NPI assigned
Oct 3, 2025
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 124375 WV Primary

Addresses

Primary practice location

2828 1St Ave Ste 510
Huntington, WV 25702-1236

Mailing address

1448 10TH Ave Ste 304
Huntington, WV 25701-3579
Phone (304) 633-1363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260225001735 WV Practitioner - Nurse Practitioner 2466933775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2828 1St Ave
Suite 510
Huntington, WV 25702-1236
Phone (304) 399-7484

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124375WVMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Medical Management, LLC CurrentSince Oct 29, 2025 Accepting new patients
St. Mary's Medical Management, LLC CurrentSince Oct 29, 2025 Accepting new patients

Locations

2828 1st Ave
Ste 510
Huntington, WV 25702
Phone (304) 399-7548

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1477427268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE STE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-633-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 510",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-399-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "KYLE",
        "middle_name": "GARRETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-03",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WV",
            "license": "124375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.