Individual provider Active NPI

Melanie Lynn Ryan, NNP-BC

  • Neonatal Nurse Practitioner
  • Portland, OR
National Provider Identifier
1083182547
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
202214962NP-PP Issued in OR
Practice address
9205 SW Barnes Rd
Portland, OR 97225-6603
Phone
(412) 841-1874
NPI assigned
Nov 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X SP019466 PA
Neonatal Nurse Practitioner 363LN0000X 202214962NP-PP OR Primary

Addresses

Primary practice location

9205 SW Barnes Rd
Portland, OR 97225-6603

Mailing address

7700 NE 72ND Ave Apt K110
Vancouver, WA 98661-1671
Phone (412) 841-1974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230504002522 OR Practitioner - Nurse Practitioner 4587029004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP019466PAMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 30, 2023 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Mar 30, 2023 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Salmon Creek Hospital Past Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Interoperability endpoints

  • Direct secure messaging: mgumina2605656@oc.providencedirect.org
  • Direct secure messaging: mryan405725@direct.childrenscolorado.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1083182547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE 72ND AVE APT K110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986611671",
            "telephone_number": "412-841-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "412-841-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MELANIE",
        "middle_name": "LYNN",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "PA",
            "license": "SP019466",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "OR",
            "license": "202214962NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.