Individual provider Active NPI

Nancy Barbara Rieder, MD

  • Pediatrics Physician
  • St. Marys, PA
National Provider Identifier
1578661880
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD041387L Issued in PA
Practice address
761 Johnsonburg Road
Suite 160
St. Marys, PA 15857
Phone
(814) 834-4399
Fax
(814) 788-8092
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101240588 VA
Pediatrics Physician 208000000X MD041387L PA Primary

Addresses

Primary practice location

761 Johnsonburg Road
Suite 160
St. Marys, PA 15857

Mailing address

763 Johnsonburg Road
St. Marys, PA 15857
Phone (814) 834-4399

Other identifiers 1

IdentifierTypeStateIssuer
0012043370004MedicaidPA

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1578661880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG ROAD",
            "city": "ST. MARYS",
            "state": "PA",
            "postal_code": "15857",
            "telephone_number": "814-834-4399",
            "fax_number": "814-788-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG ROAD",
            "address_2": "SUITE 160",
            "city": "ST. MARYS",
            "state": "PA",
            "postal_code": "15857",
            "telephone_number": "814-834-4399",
            "fax_number": "814-788-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDER",
        "first_name": "NANCY",
        "middle_name": "BARBARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101240588",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD041387L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012043370004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.