Individual provider Active NPI

Amy C Kryder, MD

  • Pediatrics Physician
  • Daleville, VA
National Provider Identifier
1598892978
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101244573 Issued in VA
Practice address
60 Market Center Way
Daleville, VA 24083-3261
Phone
(540) 992-1251
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101244573 VA Primary

Addresses

Primary practice location

60 Market Center Way
Daleville, VA 24083-3261

Mailing address

60 Market Center Way
Daleville, VA 24083-3261
Phone (540) 992-1251

Other identifiers 1

IdentifierTypeStateIssuer
1598892978MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090130000539 VA Practitioner - Pediatric Medicine 5991869257 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Jan 4, 2010 Accepting new patients
Carilion Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Carilion Healthcare Corporation CurrentSince Jan 4, 2010 Accepting new patients
Carilion Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

60 Market Center Way
Daleville, VA 24083
Phone (540) 992-1251

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

Interoperability endpoints

  • Direct secure messaging: akryder3896@direct.carilionclinic.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1598892978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MARKET CENTER WAY",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240833261",
            "telephone_number": "540-992-1251",
            "fax_number": "540-992-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MARKET CENTER WAY",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240833261",
            "telephone_number": "540-992-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYDER",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101244573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598892978",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daleville, VA

Sources for this page

Verify at the official NPI Registry.