Individual provider Active NPI

Ryan Michael Anyanwu

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1073851770
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09054 Issued in TX
Practice address
3501 W Holcombe Blvd
Houston, TX 77025-1313
Phone
(281) 407-9341
NPI assigned
Jan 30, 2013
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2453 SC
Physician Assistant 363A00000X 0010-06077 NC
Physician Assistant 363A00000X PA09054 TX Primary

Addresses

Primary practice location

3501 W Holcombe Blvd
Houston, TX 77025-1313

Mailing address

5717 Albemarle Rd
Charlotte, NC 28212-1634

Other practice location 1

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160127002556 NC Practitioner - Physician Assistant 5698078418 Reassigns benefits to 7 organizations
I20230930000578 TX Practitioner - Physician Assistant 5698078418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Urgent Care and Family Care of WNC PLLCGroup PAC ID 2567713332, 75 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

10102 Johnston Rd
Charlotte, NC 28210-8203
Phone (704) 247-6578

1090 NE Gateway CT NE
Suite 202
Concord, NC 28025-2423
Phone (704) 403-9050

119 Market Place Ave
Suite D
Mooresville, NC 28117-9157
Phone (704) 801-9140

12016 Lemmond Farm Dr
Charlotte, NC 28227-8353

12905 Rosedale Hill Ave
Huntersville, NC 28078-3341
Phone (704) 801-1000

14001 E Independence Blvd
Suite C
Indian Trail, NC 28079-9658
Phone (704) 247-6598

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

1426 E Morehead St
Charlotte, NC 28204-2926
Phone (704) 446-6090

1802 E Main St
Lincolnton, NC 28092-3915
Phone (980) 212-2610

3320 Robinwood Rd
Suite 100
Gastonia, NC 28054-6689
Phone (980) 487-2930

340 Jake Alexander Blvd W
Suite 105
Salisbury, NC 28147-1364
Phone (704) 403-6240

50 Miller St
Suite C
Winston Salem, NC 27104-4206
Phone (336) 310-5535

5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150

5727 Prosperity Crossing Dr
Suite 1100
Charlotte, NC 28269-5604
Phone (704) 863-9930

6030 W Hwy 74
Indian Trail, NC 28079-3469

613 E Roosevelt Blvd
Monroe, NC 28112-5124
Phone (704) 283-8193

703 Leonard Ave
Albemarle, NC 28001-5257
Phone (704) 550-0050

910 E Innes St
Salisbury, NC 28144-4638
Phone (844) 266-8268

9121 Sam Furr Rd
Suite 108
Huntersville, NC 28078-8235
Phone (704) 324-3590

9325 JW Clay Blvd
Suite 221
Charlotte, NC 28262-5411
Phone (704) 863-9050

9332 S Tryon St
Charlotte, NC 28273-3108
Phone (704) 587-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA09054TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 16, 2020 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 16, 2020 Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Nov 1, 2017 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 7, 2015 Accepting new patients
Mecklenburg Medical Group CurrentSince Aug 10, 2020 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 7, 2015 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 1, 2023 Accepting new patients
Caromont Medical Group Inc CurrentSince Dec 1, 2020 Accepting new patients
Carolina Medicorp Enterprises Inc Physician Assistant Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150

9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

9121 Sam Furr Rd
Ste 108
Huntersville, NC 28078
Phone (704) 324-3590

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: ranyanwu342137@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: ranyanwu709551@direct.novanthealth.org

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1073851770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 ALBEMARLE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282121634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770251313",
            "telephone_number": "281-407-9341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5717 Albemarle Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282121634",
            "country_code": "US",
            "telephone_number": "704-563-2150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2453",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06077",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.