Individual provider Active NPI

Mary C Ruder, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Athens, GA
National Provider Identifier
1982731592
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2554 Issued in KS
Practice address
110 Pioneer Dr
Athens, GA 30605-4016
Phone
(540) 471-9510
NPI assigned
Feb 28, 2007
Last updated
Sep 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2554 KS Primary

Addresses

Primary practice location

110 Pioneer Dr
Athens, GA 30605-4016

Mailing address

110 Pioneer Dr
Athens, GA 30605-4016
Phone (540) 471-9510

Other names 1

  • Katie Ruder Other name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2554KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arrow Speech Company Speech-Language Pathologist CurrentSince Nov 20, 2022 Accepting new patients

Locations

1060 Gaines School Rd
Ste A2
Athens, GA 30605
Phone (706) 351-1594

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1982731592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PIONEER DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306054016",
            "telephone_number": "540-471-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PIONEER DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306054016",
            "telephone_number": "540-471-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDER",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "RUDER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.