Active NPI
Ryan Stewart Thompson, M.D.
- Family Medicine Physician
- Murphys, CA
National Provider Identifier
1104898386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G058580
- Practice address
- 150 Big Trees Rd Ste E
Murphys, CA 95247-9101 - Phone
- (209) 728-2021
- Fax
- (209) 728-8752
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G058580 | CA | Primary |
Addresses
Primary practice location
150 Big Trees Rd Ste E
Murphys, CA 95247-9101
Mailing address
PO Box 1049
Murphys, CA 95247-1049
Phone (209) 728-2021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G585801 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58580 | CA | MD | General Practice Dentistry |
| G058580 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandra J. Shetzline, DO Inc | Family Medicine | Past | Accepting new patients |
| Mind Matters Clinic | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Marriage & Family Therapist
- Murphys, CA
- NPI 1336560747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1104898386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1049",
"city": "MURPHYS",
"state": "CA",
"postal_code": "952471049",
"telephone_number": "209-728-2021",
"fax_number": "209-728-8752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 BIG TREES RD STE E",
"city": "MURPHYS",
"state": "CA",
"postal_code": "952479101",
"telephone_number": "209-728-2021",
"fax_number": "209-728-8752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "RYAN",
"middle_name": "STEWART",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G058580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G585801",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Murphys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.