Timothy Peter Ryan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

949-L Issued in MS

Practice address

2500 N State St
Department of Medicine
Jackson, MS 39216

Phone

(601) 984-5601

Fax

(601) 984-6601

NPI assigned

Jul 13, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1063896868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "160-166-7699",
            "fax_number": "601-984-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-5601",
            "fax_number": "601-984-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TIMOTHY",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "949-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura E Rutledge, LPC
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• Mary Kelly Ryals, CRNA
• Kayla Ryan
• Michael Ryan
• S & R Divine Homecare Services LLC
• S & S Transportation
• S Songcharoen MD, Facs, PLLC
• S.H.E., LLC
• Ashley Sabbatini, AGACNP

• Internal Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.