Active NPI
Stephanie Jane Ryder, LCSW
- Clinical Social Worker
- Nags Head, NC
National Provider Identifier
1982188397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C014620
- Practice address
- 119 W Wood Hill Dr Ste 5
Nags Head, NC 27959-8700 - Phone
- (252) 489-6373
- NPI assigned
- Sep 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PO12429 | NC | |
| Clinical Social Worker | 1041C0700X | C014620 | NC | Primary |
Addresses
Primary practice location
119 W Wood Hill Dr Ste 5
Nags Head, NC 27959-8700
Mailing address
PO Box 1941
Kill Devil Hills, NC 27948-1941
Phone (252) 489-0026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2023 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO12429 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649462400000",
"number": "1982188397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1941",
"city": "KILL DEVIL HILLS",
"state": "NC",
"postal_code": "279481941",
"telephone_number": "252-489-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 W WOOD HILL DR STE 5",
"city": "NAGS HEAD",
"state": "NC",
"postal_code": "279598700",
"telephone_number": "252-489-6373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYDER",
"first_name": "STEPHANIE",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-21",
"last_updated": "2022-04-09",
"certification_date": "2022-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "PO12429",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C014620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nags Head, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.