Michael Ryan, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT15572 Issued in FL

Practice address

1312 3Rd St N
Jacksonville Beach, FL 32250-7348

Phone

(904) 465-5277

NPI assigned

Oct 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477180800000",
    "number": "1003367202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 SUMMERFIELD DR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 3RD ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322507348",
            "telephone_number": "904-465-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "credential": "PT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-23",
        "last_updated": "2016-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT15572",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Rudolph, COA LL
• Kayli Rushing
• Kara Lynn Russell, ARNP
• Amy Rutledge, PHARMD
• Kenneth C Ryan, APRN
• Jessica Sada, M.A. CCC-SLP
• Shonda Salisbury, LCSW
• Redner Javier Salonga
• Salus Medical Consultants, LLC
• Samson Strength & Performance PT

• Physical Therapist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2016; 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.