Individual provider Active NPI

Lisa Rider, MD

  • Pediatric Rheumatology Physician
  • Bethesda, MD
National Provider Identifier
1669566691
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
D46950 Issued in MD
Practice address
Clinical Research Ctr
10 Center Drive
Bethesda, MD 20892-0001
Phone
(301) 496-1211
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X MD035811 DC
Pediatric Rheumatology Physician 2080P0216X D46950 MD Primary

Addresses

Primary practice location

Clinical Research Ctr
10 Center Drive
Bethesda, MD 20892-0001

Mailing address

Niehs Nih
CRC 4-2352, MSC 1301, 10 Center Drive
Bethesda, MD 20892-0001
Phone (301) 451-6272

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

State licenses

LicenseStateTypeSpecialty
MD035811DCMDPediatric Rheumatology Physician
D46950MDMDPediatric Rheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238716800000",
    "number": "1669566691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NIEHS NIH",
            "address_2": "CRC 4-2352, MSC 1301, 10 CENTER DRIVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-451-6272",
            "fax_number": "301-451-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICAL RESEARCH CTR",
            "address_2": "10 CENTER DRIVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208920001",
            "telephone_number": "301-496-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "LISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "DC",
            "license": "MD035811",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MD",
            "license": "D46950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; 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.