Active NPI
Ryan Horan, O.D.
- Optometrist
- Lawrenceville, GA
National Provider Identifier
1104172477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18003758A
- Practice address
- 2000 Newpoint Pkwy Ste 100
Lawrenceville, GA 30043-5582 - Phone
- (678) 892-3773
- NPI assigned
- Jul 24, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003758A | IN | Primary |
Addresses
Primary practice location
2000 Newpoint Pkwy Ste 100
Lawrenceville, GA 30043-5582
Mailing address
4051 S Creekside Dr
New Palestine, IN 46163-9107
Phone (317) 694-9886
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18003758A | IN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343088000000",
"number": "1104172477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4051 S CREEKSIDE DR",
"city": "NEW PALESTINE",
"state": "IN",
"postal_code": "461639107",
"telephone_number": "317-694-9886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 NEWPOINT PKWY STE 100",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300435582",
"telephone_number": "678-892-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORAN",
"first_name": "RYAN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-24",
"last_updated": "2012-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18003758A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.