Ryan Glenn Hartig, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01076905A Issued in IN

Practice address

4666 W Jefferson Blvd Ste 170
Fort Wayne, IN 46804-6893

Phone

(260) 207-4137

NPI assigned

Sep 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Fort Wayne Endocrinology PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Wayne, IN
  • NPI 1285786111
  Medicare reassignment NPD
• American Kidney Clinics LLC

  • Nephrology Physician
  • Fort Wayne, IN
  • NPI 1609699628
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1053747741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4666 W JEFFERSON BLVD STE 170",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4666 W JEFFERSON BLVD STE 170",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046893",
            "telephone_number": "260-207-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTIG",
        "first_name": "RYAN",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01076905A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Lee Harter
• Julia Harter, PT
• Julianne Marie Harter, MA, LMHC
• Mary Harter, RD
• William Andrew Harter, MD
• Marlona Kay Harting, D.O.
• Michael Anthony Hartle, D.C.
• Holly Mae Hartley, MS, LAT, ATC
• Linda L Hartley, MSW, LCSW
• Alyssa Renee Hartman

• General Practice Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.