SCOTT J CRYDER (NPI# 1215018205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215018205 |
| Entity Type | Individual |
| Full Name | SCOTT J CRYDER |
| Credential | PA-C |
| Practice Address |
819 State Route 664 N Logan OH 43138 |
| Mailing Address |
Po Box 228 Logan OH 43138-0228 |
| Practice Telephone | 7403808140 |
| Practice Fax Number | 7403808150 |
| Mailing Telephone | 7403804181 |
| Mailing Fax Number | 7403850865 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2019-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
50002332 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM | 000000547134 | 01 |
| OH | 2330150 | 05 | |
| OH | UHC | 2553018 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 31490 Chieftain Dr, Suite A, Logan, OH 431388420 | 7403858474 | 7403855095 |
| Street Address |
819 STATE ROUTE 664 N |
| City | LOGAN |
| State | OH |
| Zip Code | 43138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235133091 | James R Hayward | Family Medicine | 819 State Route 664 N, Ste A, Logan, OH 43138-8540 | 2005-06-09 |
| 1144302639 | Alexander Samuel Whidden | Nurse Anesthetist, Certified Registered | 819 State Route 664 N, Suite A, Logan, OH 43138-8540 | 2006-10-20 |
| 1801994827 | Hocking Valley Medical Group, Inc. | General Practice | 819 State Route 664 N, Suite A & B, Logan, OH 43138-8540 | 2006-09-21 |
| 1952319246 | Lancaster Surgical Associates, Inc. | Surgery | 819 State Route 664 N, Logan, OH 43138-8540 | 2006-08-03 |
| 1962498089 | Mark A Holt | Orthopaedic Surgery | 819 State Route 664 N, Logan, OH 43138-8540 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538667696 | Kelsey Whalen | Social Worker | 541 Sr 93 N, Suite C, Logan, OH 43138 | 2018-01-24 |
| 1144728205 | Raeann Harry-boothe | Counselor | 313 Chieftain Dr, Logan, OH 43138 | 2018-01-24 |
| 1336661784 | Megan Correll | Nurse Practitioner | 541 Sr 664n, Suite C, Logan, OH 43138 | 2017-07-07 |
| 1841735800 | Coler Drug Logan, Ltd | Durable Medical Equipment & Medical Supplies | 21 Hocking Mall, Logan, OH 43138 | 2016-12-30 |
| 1932515418 | Melissa O'harra-brown | Nurse Practitioner | 541 Sr 664 N, Suite C, Logan, OH 43138 | 2014-07-07 |
| 1790198950 | Matthew R Williams | Audiologist | 1323 West Hunter St., Logan, OH 43138 | 2014-06-05 |
| 1194138651 | Diles Logan Hearing Center, L.L.C. | Audiologist | 1323 West Hunter Street, Logan, OH 43138 | 2014-06-03 |
| 1205252210 | Shaun Crisp | Occupational Therapy Assistant | 601 Ohio 664, Hocking Valley Community Hospital, Logan, OH 43138 | 2014-03-14 |
| 1467780056 | Natalie Simpson | Licensed Practical Nurse | 583 E Second St, Logan, OH 43138 | 2009-11-20 |
| 1821243262 | Angela Rose Hartbarger | Counselor | 541 St. Rt. 664, Suite C, Logan, OH 43138 | 2008-11-26 |
| Find all providers in zip 43138 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508418260 | Collin Dees | Physician Assistant | Tripoint Medical Center, 7590 Auburn Road, Painesville, OH 44077 | 2019-07-12 |
| 1811469968 | Cody Tyler Delaney | Physician Assistant | 1711 27th St Ste 306, Portsmouth, OH 45662-2669 | 2018-12-28 |
| 1861936155 | Surgical Fusion, LLC | Physician Assistant | 605 N High St # 237, Columbus, OH 43215-2024 | 2016-12-06 |
| 1225481690 | Rebekah Keesee | Physician Assistant | 1045 Arundel Ave, Westerville, OH 43081-1188 | 2016-07-20 |
| 1568814382 | Kristen Cipolla | Physician Assistant | 1049 Scarlet Oak Dr Apt D, Hudson, OH 44236-4542 | 2016-07-05 |
| 1932560083 | Adam Peckinpaugh | Physician Assistant | 2109 Hughes Drive #450, Jobst Vascular Institute, Toledo, OH 43606-5102 | 2016-03-17 |
| 1710348701 | Alex Blake | Physician Assistant | 10743 S State Route 133, Blanchester, OH 45107-9435 | 2016-03-17 |
| 1215319926 | Richard Alan Stevenson | Physician Assistant | 187 Vine St, Fairborn, OH 45324-3324 | 2015-06-18 |
| 1548641038 | Matthew Hamley | Physician Assistant | 2315 Birch Trace Dr, Youngstown, OH 44515-4914 | 2015-06-10 |
| 1588094148 | Kevin W. Rotondo | Physician Assistant | 1732 Maple St, Wickliffe, OH 44092-2423 | 2013-11-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.