Active NPI
Doris Odell Ryan, PH.D., HSPP
- Clinical Psychologist
- Avon, IN
National Provider Identifier
1073567889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20041969A
- Practice address
- 6655 US 36 East
Cummins Behavioral Health Services
Avon, IN 46123 - Phone
- (317) 272-3330
- Fax
- (317) 272-0807
- NPI assigned
- May 19, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20041969A | IN | Primary |
Addresses
Primary practice location
6655 US 36 East
Cummins Behavioral Health Services
Avon, IN 46123
Mailing address
5101 E US Highway 36
Ste 100
Avon, IN 46123-6646
Phone (317) 347-0625
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000342263 | Other | IN | ANTHEM BCBS PROVIDER PIN |
| 200305580 | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505779200000",
"number": "1073567889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5101 E US HIGHWAY 36",
"address_2": "STE 100",
"city": "AVON",
"state": "IN",
"postal_code": "461236646",
"telephone_number": "317-347-0625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 US 36 EAST",
"address_2": "CUMMINS BEHAVIORAL HEALTH SERVICES",
"city": "AVON",
"state": "IN",
"postal_code": "46123",
"telephone_number": "317-272-3330",
"fax_number": "317-272-0807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "DORIS",
"middle_name": "ODELL",
"credential": "PH.D., HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2017-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20041969A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS PROVIDER PIN",
"identifier": "000000342263",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200305580",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.