Active NPI
Albert Edward Ryckman, MD
- Gastroenterology Physician
- Albany, OR
National Provider Identifier
1750341905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD15106
- Practice address
- 631 Elm St. SW
Suite 202
Albany, OR 97321 - Phone
- (541) 926-1125
- Fax
- (541) 926-3704
- NPI assigned
- Mar 23, 2006
- Last updated
- Mar 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MD15106 | OR | Primary |
Addresses
Primary practice location
631 Elm St. SW
Suite 202
Albany, OR 97321
Mailing address
631 Elm St. SW
Suite 202
Albany, OR 97321
Phone (541) 926-1125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146506 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD15106 | OR | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269475200000",
"number": "1750341905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 ELM ST. SW",
"address_2": "SUITE 202",
"city": "ALBANY",
"state": "OR",
"postal_code": "97321",
"telephone_number": "541-926-1125",
"fax_number": "541-926-3704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 ELM ST. SW",
"address_2": "SUITE 202",
"city": "ALBANY",
"state": "OR",
"postal_code": "97321",
"telephone_number": "541-926-1125",
"fax_number": "541-926-3704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYCKMAN",
"first_name": "ALBERT",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2010-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OR",
"license": "MD15106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "146506",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.