Jerry Judd Pryde Jr., MD, MPH

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A060849 Issued in CA

Practice address

1130 S. Flower St #412
Los Angeles, CA 90015-2144

Phone

(310) 423-2182

Fax

(213) 403-4373

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jpryde103528@direct.cshs.org

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.

• Jerry Judd Pryde Jr MD PC

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
  • NPI 1861766982
  NPD (past)
• Jerry Judd Pryde Jr., M.D., P.C.

  • Specialist
  • Los Angeles, CA
  • NPI 1891908018
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1558479147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S. FLOWER ST #412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152144",
            "telephone_number": "310-423-2182",
            "fax_number": "213-403-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S. FLOWER ST #412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152144",
            "telephone_number": "310-423-2182",
            "fax_number": "213-403-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYDE",
        "first_name": "JERRY",
        "middle_name": "JUDD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A060849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oronica Pruitt
• Janessa Martinez Prum, BS, SLP-A
• Crystle Prung, PH.D.
• PRX Pharmacorp
• Yehudah Pryce, DSW, LCSW
• Jennifer Monzell Pryer
• Arthur Edward Pryor Jr., MD
• Keli Nicole Pryor
• Sara Pryor
• Jason J Prystowsky, MD

• Physical Medicine & Rehabilitation Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.