Active NPI
Thomas Donald Ryan, M.D.
- Pediatrics Physician
- Cartersville, GA
National Provider Identifier
1043320138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 042415
- Practice address
- 20 Collins Dr
Suite B
Cartersville, GA 30120-2486 - Phone
- (770) 607-0795
- Fax
- (770) 607-1339
- NPI assigned
- Aug 30, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 042415 | GA | Primary |
Addresses
Primary practice location
20 Collins Dr
Suite B
Cartersville, GA 30120-2486
Mailing address
20 Collins Dr
Suite B
Cartersville, GA 30120-2486
Phone (770) 607-0795
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002618 | Other | GA | BCBSGA |
| 10032515 | Other | GA | AMERIGROUP |
| 12-01508 | Other | GA | UNITED HEALTH CARE |
| 303401 | Other | GA | WELLCARE OF GA |
| 5925435 | Other | GA | CIGNA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042415 | GA | MD | Pediatrics Physician |
Interoperability endpoints
- drryan@drtomryan.kareodirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043320138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 COLLINS DR",
"address_2": "SUITE B",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301202486",
"telephone_number": "770-607-0795",
"fax_number": "770-607-1339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 COLLINS DR",
"address_2": "SUITE B",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301202486",
"telephone_number": "770-607-0795",
"fax_number": "770-607-1339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "THOMAS",
"middle_name": "DONALD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "042415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSGA",
"identifier": "002618",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10032515",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "12-01508",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE OF GA",
"identifier": "303401",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5925435",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cartersville, 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.