Ryan James Kelly

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

702 Sunset Dr
Ontario, OR 97914-3121

Phone

(541) 889-9176

Fax

(541) 889-7873

NPI assigned

May 4, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, ID2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeways IncGroup PAC ID 4183696214, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lifeways, Inc

  • Community/Behavioral Health Agency
  • Ontario, OR
  • NPI 1568558955

  Community/Behavioral Health, OR

  Medicare reassignment Care Compare group NPD
• Accredit Therapy Solutions

  • Clinical Social Worker
  • Boise, ID
  • NPI 1952263840

  Clinical

  NPD Authorized official
• Lifeways, Inc

  • Psychiatric Hospital
  • Boise, ID
  • NPI 1437620358
  Care Compare group
• Lifeways, Inc

  • Psychiatric Residential Treatment Facility
  • Hermiston, OR
  • NPI 1144761784
  NPD
• Lifeways, Inc

  • Community/Behavioral Health Agency
  • Pendleton, OR
  • NPI 1932295326

  Community/Behavioral Health

  NPD

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1013590272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9176",
            "fax_number": "541-889-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9176",
            "fax_number": "541-889-7873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 E Fleetwood Ct",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837065176",
            "country_code": "US",
            "telephone_number": "208-777-5122",
            "fax_number": "208-777-5122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Joseph Judson, O.D.
• Kenzie D Kaba
• Carla Kautz
• Mark Keele
• Kristi Kellogg
• Sandra Kendall
• John R Kerfoot, CRNA
• Justin Michael Kesler
• Jason William Adam Kimbley, CADC
• Jennifer King, FNP-BC

• All providers in Ontario, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.