Active NPI
Ryder From
- Rehabilitation Practitioner
- Las Vegas, NV
National Provider Identifier
1962195453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 8685 S Eastern Ave
Las Vegas, NV 89123-2839 - Phone
- (702) 754-0807
- NPI assigned
- May 31, 2023
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | NV | Primary |
Addresses
Primary practice location
8685 S Eastern Ave
Las Vegas, NV 89123-2839
Mailing address
12282 Azure Gate Rd Unit 3
Las Vegas, NV 89183-5881
Phone (847) 521-9903
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1962195453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12282 AZURE GATE RD UNIT 3",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891835881",
"telephone_number": "847-521-9903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8685 S EASTERN AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891232839",
"telephone_number": "702-754-0807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FROM",
"first_name": "RYDER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-31",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NV",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.