Edward G Rydell, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

21831 Issued in WI

Practice address

191 Theater Road
Onalaska, WI 54650-8679

Phone

(608) 392-5001

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1922084706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 THEATER ROAD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508679",
            "telephone_number": "608-392-5001",
            "fax_number": "952-993-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATER ROAD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508679",
            "telephone_number": "608-392-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDELL",
        "first_name": "EDWARD",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "23778",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "21831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah C Rudie, APNP
• Matthew R Runde, MD
• Robert D Ruprecht
• Rusty Russell
• Kayla Ryba, LPC
• Jonathan Sabin, CSAC
• Vijay K Sabnis, M.D.
• Sam'S Club Optical
• Tyler Brett Sawall, RPH
• David R Sawicki, DC

• Emergency Medicine Physician in Onalaska, WI
• Providers in Onalaska, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.