Active NPI
Edward Davis Ryan, PT
- Geriatric Physical Therapist
- Gainesville, GA
National Provider Identifier
1013132869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- PT008101
- Practice address
- 1626 Hastings CT
Gainesville, GA 30504-2629 - Phone
- (678) 936-0343
- Fax
- (678) 450-6931
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | PT008101 | GA | Primary |
Addresses
Primary practice location
1626 Hastings CT
Gainesville, GA 30504-2629
Mailing address
1626 Hastings CT
Gainesville, GA 30504-2629
Phone (678) 936-0343
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT008101 | GA | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013132869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 HASTINGS CT",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305042629",
"telephone_number": "678-936-0343",
"fax_number": "678-450-6931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1626 HASTINGS CT",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305042629",
"telephone_number": "678-936-0343",
"fax_number": "678-450-6931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "EDWARD",
"middle_name": "DAVIS",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "GA",
"license": "PT008101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, GA
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.