Ryder Medical PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

30354 Issued in AZ

Legal business name

RYDER MEDICAL PC

Practice address

1020 N San Francisco St Ste 100
Flagstaff, AZ 86001-3281

Phone

(602) 273-6770

Fax

(888) 975-1546

NPI assigned

Dec 7, 2017

Organization subpart

No

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

Authorized official

Name

Judith Kelley, MDNPI 1023027661

Title

Director

Phone

(602) 273-6770

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith Amanda Kelley, MD

  • Anesthesiology Physician
  • Flagstaff, AZ
  • NPI 1023027661

  Anesthesiology, AZ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1497260780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N SAN FRANCISCO ST STE 100",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013281",
            "telephone_number": "602-273-6770",
            "fax_number": "888-975-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYDER MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-07",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-273-6770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "30354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Internal Medicine PC
• Keith T Ryan, MD
• Sandra Ann Ryan, M.A., CCC-LP
• Matthew Scott Rybka, MD
• Matthew Kevin Rydberg, MD
• Matthew Rysdyk, ATC
• Mathew Sabicer, RN
• Nicolette Suzanne Sachs, LCSW
• Sacred Peaks Health Center DME
• Jermaine Isip Saddi-Alvarez

• All providers in Flagstaff, AZ
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.