Individual provider Active NPI

Jeffrey Rydbeck, LPTA

  • Alzheimer Center (Dementia Center)
  • North Andover, MA
National Provider Identifier
1831410463
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
08313 Issued in MA
Practice address
140 Prescott Street
North Andover, MA 01845-1826
Phone
(978) 685-8086
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X 08313 MA Primary

Addresses

Primary practice location

140 Prescott Street
North Andover, MA 01845-1826

Mailing address

5 Lakeshore Drive
Georgetown, MA 01833

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
08313MAMDAlzheimer Center (Dementia Center)

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1831410463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAKESHORE DRIVE",
            "city": "GEORGETOWN",
            "state": "MA",
            "postal_code": "01833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PRESCOTT STREET",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018451826",
            "telephone_number": "978-685-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDBECK",
        "first_name": "JEFFREY",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MA",
            "license": "08313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.

Verify at the official NPI Registry.