Individual provider Active NPI

Sandra Wagner Ryden, MSW, LCSW,

  • Clinical Social Worker
  • Norman, OK
National Provider Identifier
1578569018
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0674 Issued in OK
Practice address
1818 W Lindsey St Ste C212
Norman, OK 73069-4159
Phone
(405) 360-7165
Fax
(405) 360-7165
NPI assigned
Jun 21, 2005
Last updated
Dec 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0674 OK Primary

Addresses

Primary practice location

1818 W Lindsey St Ste C212
Norman, OK 73069-4159

Mailing address

PO Box 5574
Norman, OK 73070-5574
Phone (405) 360-7165

Other identifiers 2

IdentifierTypeStateIssuer
100707540AMedicaidOK
0007391110OtherAETNA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0674OKMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1578569018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5574",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730705574",
            "telephone_number": "405-360-7165",
            "fax_number": "405-360-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 W LINDSEY ST STE C212",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730694159",
            "telephone_number": "405-360-7165",
            "fax_number": "405-360-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDEN",
        "first_name": "SANDRA",
        "middle_name": "WAGNER",
        "name_prefix": "Miss",
        "credential": "MSW, LCSW,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "0674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100707540A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007391110",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.