Individual provider Active NPI

Shaida Khajenasir Ryan, M.D.

  • Specialist
  • Durham, NC
National Provider Identifier
1003824616
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1515 W NC Highway 54 Ste 210
Durham, NC 27707-5576
Phone
(919) 452-5826
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NC Primary

Addresses

Primary practice location

1515 W NC Highway 54 Ste 210
Durham, NC 27707-5576

Mailing address

PO Box 52666
Durham, NC 27717-2666
Phone (919) 452-5826

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200501819NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Medical Anesthesiology Group, Inc. Past Accepting new patients
Salem Professional Anesthesia Services PC PastSince May 20, 2016 Accepting new patients
Anesthesia Care, PLLC Specialist Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003824616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52666",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277172666",
            "telephone_number": "919-452-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W NC HIGHWAY 54 STE 210",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075576",
            "telephone_number": "919-452-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SHAIDA",
        "middle_name": "KHAJENASIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.