Jennifer Ryu, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R209439 Issued in MD

Practice address

6100 Dobbin Rd
Columbia, MD 21045-5804

Phone

(443) 492-4000

NPI assigned

Mar 1, 2018

Sex

Female

Sole proprietor

No

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Greater Baltimore Medical Center, Inc

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
  • NPI 1891855763
  Medicare reassignment NPD
• Greater Baltimore Medical Center, Inc.

  • Ophthalmology Physician
  • Baltimore, MD
  • NPI 1164675906
  NPD
• Greater Baltimore Medical Center, Inc.

  • Sleep Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1538029731
  NPD

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1629570049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 GUILFORD RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 DOBBIN RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455804",
            "telephone_number": "443-492-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYU",
        "first_name": "JENNIFER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R209439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James E Rutledge, PSYD, MFS
• Jennifer Rutter, RBT
• Ruxton Supply Services, LLC
• Aiden Ryan
• Donna Keefe Ryder, RN
• S-Ganginis, LLC
• S.K. Vaswani, MD,PA
• Mazen M Saad, DDS
• Priscilla Saah, RN
• Richard Saavedra

• Pediatric Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.