Individual provider Active NPI

Carey Ryan, PT

  • Physical Therapist
  • Saint Clair Shores, MI
National Provider Identifier
1023340122
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010800 Issued in MI
Practice address
24345 Harper Ave
Saint Clair Shores, MI 48080-1285
Phone
(586) 563-3300
Fax
(586) 563-3313
NPI assigned
Feb 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501010800 MI Primary

Addresses

Primary practice location

24345 Harper Ave
Saint Clair Shores, MI 48080-1285

Mailing address

21700 Sunnydale St
Saint Clair Shores, MI 48081-2804
Phone (586) 350-5513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000123 MI Practitioner - Physical Therapist in Private Practice 3173598448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Medicine, P.C.Group PAC ID 1759394349, 2 clinicians

Practice addresses (Care Compare)

24345 Harper Ave
Saint Clair Shores, MI 48080-1285
Phone (586) 563-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Medicine, P.C. CurrentSince Apr 5, 2011 Accepting new patients
The Recovery Project, LLC Physical Therapist PastSince Mar 6, 2022 Accepting new patients

Locations

24345 Harper Ave
St Clr Shores, MI 48080
Phone (586) 563-3300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFFBAA/Endpoint/GFFBAA

Organizations & group practices 2

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1023340122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21700 SUNNYDALE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812804",
            "telephone_number": "586-350-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24345 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801285",
            "telephone_number": "586-563-3300",
            "fax_number": "586-563-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CAREY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.