Organization Active NPI

Takoma Park Gynecology LLC

  • Advanced Practice Midwife
  • Takoma Park, MD
National Provider Identifier
1841898426
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Legal business name
TAKOMA PARK GYNECOLOGY LLC
Practice address
7050 Carroll
Suite 201
Takoma Park, MD 20912
Phone
(301) 960-1155
Fax
(301) 690-0097
NPI assigned
Oct 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Carina Ryder, CNMNPI 1942460415
Title
Practitioner
Phone
(301) 960-1155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X Primary

Addresses

Primary practice location

7050 Carroll
Suite 201
Takoma Park, MD 20912

Mailing address

7050 Carroll
Suite 201
Takoma Park, MD 20912
Phone (301) 960-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221012003193 DC Part B Supplier - Clinic/Group Practice 0840666038 Receives reassigned benefits from 2 practitioners
Practice locations: Takoma Park, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2240648Takoma Park Gynecology7050 Carroll Ave Suite 201, Takoma Park, MD 20912Provider-performed microscopyOct 20, 2027

National Provider Directory

National Provider Directory

Locations

7050 Carroll Ave
Ste 201
Takoma Park, MD 20912
Phone (301) 960-1155

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1841898426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 CARROLL",
            "address_2": "SUITE 201",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "20912",
            "telephone_number": "301-960-1155",
            "fax_number": "301-690-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 CARROLL",
            "address_2": "SUITE 201",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "20912",
            "telephone_number": "301-960-1155",
            "fax_number": "301-690-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKOMA PARK GYNECOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "RYDER",
        "authorized_official_first_name": "CARINA",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "301-960-1155",
        "authorized_official_credential": "CNM"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.