Carrie Renee Rydstrom

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

711 Onyx St
Kemmerer, WY 83101-3214

Phone

(307) 877-4496

NPI assigned

May 22, 2025

Sex

Female

Sole proprietor

Yes

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 NV

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Speakeasy Therapy Services LLCGroup PAC ID 3870867369, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Speakeasy Therapy Services, LLC

  • Speech-Language Pathologist
  • Las Vegas, NV
  • NPI 1114315801

  NV, Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1750173886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1179",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831011179",
            "telephone_number": "605-670-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ONYX ST",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831013214",
            "telephone_number": "307-877-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDSTROM",
        "first_name": "CARRIE",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PG Direct Care LLC
• Ridley'S Family Markets Inc
• Robert P. Tyrrell, D.D.S.
• Karl D Robinson, DDS
• Phillip Robert Rutledge, PA
• Amy Schaffarzick, SLP-CCC
• Robert D. Schaffarzick, O.D.
• Scherr Chiropractic Clinic
• Chad William Seiler, MD
• Wesley Rick Somers, RPH

• All providers in Kemmerer, WY
• Speech-Language Pathologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.