Connor Lee Ryan, PT, DPT, CSCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

12204PT Issued in AZ

Practice address

3336 E Chandler Heights Rd
Ste 126
Gilbert, AZ 85298-4259

Phone

(480) 840-6125

Fax

(480) 840-6122

NPI assigned

Sep 25, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1073915666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 E ROSS DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852259040",
            "telephone_number": "508-864-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 E CHANDLER HEIGHTS RD",
            "address_2": "STE 126",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984259",
            "telephone_number": "480-840-6125",
            "fax_number": "480-840-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CONNOR",
        "middle_name": "LEE",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-25",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "12204PT",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036910-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01539700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Dawn Russo
• Bartley Chad Rust, PA-C
• Jeffery Scott Rust, P.A
• RV Healthcare LLC
• Rviv Wellness LLC
• George W Ryback, MD
• Ryken-NDFC, LLC
• Anne Sabatini, LAC
• Sabic Foot Ankle & Lower Leg Specialists PLLC
• Nichole Sablan, LPC, LPCC

• Orthopedic Physical Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.