Individual provider Active NPI

Christopher S Rydzewski

  • Speech-Language Pathologist
  • Spartanburg, SC
National Provider Identifier
1619265345
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
110 Summit Hills Dr
Spartanburg, SC 29307-1532
Phone
(864) 582-5561
NPI assigned
Jul 15, 2011
Last updated
Jul 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

110 Summit Hills Dr
Spartanburg, SC 29307-1532

Mailing address

110 Summit Hills Dr
Spartanburg, SC 29307-1532
Phone (864) 582-5561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201207002702 SC Practitioner - Qualified Speech Language Pathologist 6709107824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Medical Group Inc Speech-Language Pathologist CurrentSince Oct 28, 2020 Accepting new patients

Locations

509 W Poinsett St
Greer, SC 29650
Phone (864) 655-7757

211 Hillcrest Dr
Laurens, SC 29360
Phone (864) 346-0391

213 E Butler Rd
Ste E2
Mauldin, SC 29662
Phone (864) 346-0391

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1619265345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SUMMIT HILLS DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071532",
            "telephone_number": "864-582-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SUMMIT HILLS DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071532",
            "telephone_number": "864-582-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDZEWSKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.