Ryan R Landoll, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004814 Issued in VA

Practice address

431 Meadowlark St
Shaw AFB, SC 29152-5019

Phone

(803) 895-6199

NPI assigned

Oct 3, 2012

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 21, 2021 through Oct 21, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• The Ross Center for Anxiety & Related Disorders Inc

  • Psychologist
  • Washington, DC
  • NPI 1417127663
  NPD (past)
• The Ross Center for Anxiety & Related Disorders, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Washington, DC
  • NPI 1578998563
  NPD (past)

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1083966824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 MEADOWLARK ST",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525019",
            "telephone_number": "803-895-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 MEADOWLARK ST",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525019",
            "telephone_number": "803-895-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDOLL",
        "first_name": "RYAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanee M James
• Jesse Jenkins, PA-C
• Alayna Renee Jones, DMD
• Vanessa Kligman, PHARM.D
• James John Labarre, R.PH, PHARM.D.
• Michelle Suzanne Larue, PT
• Rhiannon Marie Leutner, PHARMD
• Jim Li
• Melissa Lincoln, PA-C
• Hanlon Ignatius Maivelett, PHARMD

• Clinical Psychologist in Shaw AFB, SC
• Providers in Shaw AFB, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.