Individual provider Active NPI

Ryan M Guillory, MD

  • Otolaryngology Physician
  • Longview, TX
National Provider Identifier
1104947175
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
N8298 Issued in TX
Practice address
912 Walnut Hill Dr
Longview, TX 75605-5052
Phone
(903) 291-6300
Fax
(903) 291-6305
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X N8298 TX Primary

Addresses

Primary practice location

912 Walnut Hill Dr
Longview, TX 75605-5052

Mailing address

912 Walnut Hill Dr
Longview, TX 75605-5052
Phone (903) 291-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000620 TX Practitioner - Otolaryngology 5294904611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Southwestern Medical School at Dallas, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan M Guillory MD PA 6 clinicians

Practice addresses (Care Compare)

912 Walnut Hill Dr
Longview, TX 75605-5052
Phone (903) 212-9456

Hospital & facility affiliations

  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan M Guillory MD PA Otolaryngology CurrentSince Jun 15, 2017 Accepting new patients
Diagnostic Clinic of Longview PA Otolaryngology Past Accepting new patients

Locations

709 Hollybrook Dr
Ste 5605
Longview, TX 75605
Phone (903) 291-6053

Interoperability endpoints

  • Direct secure messaging: ryan.guillory@etent.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/EJIJAD/Endpoint/EJIJAD

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1104947175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055052",
            "telephone_number": "903-291-6300",
            "fax_number": "903-291-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055052",
            "telephone_number": "903-291-6300",
            "fax_number": "903-291-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "RYAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "N8298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.