{
"Npi": {
"NPI": "1033251400",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RYDER",
"FirstName": "KELLY",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LETSINGER",
"OtherFirstName": "KELLY",
"OtherMiddleName": "RYDER",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "M.D.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "919 HIDDEN RDG",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "IRVING",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75038-3813",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "469-282-2711",
"MailingAddressFaxNumber": "469-282-0996",
"FirstLinePracticeLocationAddress": "3330 MASONIC DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALEXANDRIA",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "71301-3841",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "318-320-4422",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/13/2007",
"LastUpdateDate": "02/07/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207RH0002X",
"TaxonomyName": "Hospice and Palliative Medicine (Internal Medicine) Physician",
"LicenseNumber": "MD.202250",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "MD.202250",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}