Active NPI
Anna E Ridder, DPT, ATC
- Physical Therapist
- Greenville, SC
National Provider Identifier
1962895482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 200 Patewood Dr Ste 250
Greenville, SC 29615-3593 - Phone
- (864) 454-0952
- NPI assigned
- Mar 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1654 | SC | |
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
200 Patewood Dr Ste 250
Greenville, SC 29615-3593
Mailing address
200 Patewood Dr Ste 250C
Greenville, SC 29615-3593
Phone (864) 454-0952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1654 | SC | MD | Family Medicine Physician |
| 11487 | SC | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenville Proaxis Therapy LLC | Current | Accepting new patients | |
| Greenville Proaxis Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Prisma Health University Medical Group | Past | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
33205 Collection Ctr Dr
Chicago, IL 60693
103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753
200 Patewood Dr
Ste 250
Greenville, SC 29615
Phone (864) 454-0952
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Greenville, SC
- NPI 1669457859
-
- Durable Medical Equipment & Medical Supplies
- Greenville, SC
- NPI 1740052000
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1962895482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR STE 250C",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153593",
"telephone_number": "864-454-0952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR STE 250",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153593",
"telephone_number": "864-454-0952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDER",
"first_name": "ANNA",
"middle_name": "E",
"credential": "DPT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-09",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1654",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.