Individual provider Active NPI

Patrick Thomas Ryan, MD

  • Pediatrics Physician
  • Rock Hill, SC
National Provider Identifier
1114040516
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61999 Issued in CT
Practice address
222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone
(803) 329-1234
NPI assigned
Apr 9, 2007
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22580 WV
Pediatrics Physician 208000000X 61999 CT Primary
Pediatrics Physician 208000000X 22580 WV
Hospitalist Physician 208M00000X 2025-03462 NC

Addresses

Primary practice location

222 Herlong Ave S
Rock Hill, SC 29732-1158

Mailing address

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

Other practice location 1

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-9740

Other identifiers 1

IdentifierTypeStateIssuer
3810011979MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, SC, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080722000687 WV Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8224101373 Reassigns benefits to 2 organizations
I20220518003085 SC Practitioner - Internal Medicine 8224101373 Reassigns benefits to 1 organization
I20251026000264 NC Practitioner - HospitalistPractitioner - Internal Medicine 8224101373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22580WVMDPediatrics Physician
2025-03462NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince May 15, 2022 Accepting new patients
Kanawha Hospice Care, Inc CurrentSince Jan 27, 2018 Accepting new patients
Greenbrier Clinic Surgery Center Current Accepting new patients
Novant Health Medical Group, LLC Internal Medicine CurrentSince Sep 15, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 15, 2025 Accepting new patients
Kanawha Hospice Care, Inc. CurrentSince Jan 27, 2018 Accepting new patients
Charleston Area Medical Center, Inc. Hospitalist CurrentSince Jun 1, 2020 Accepting new patients
BJSM Med Inc Past Accepting new patients
Amisub of South Carolina, Inc. Past Accepting new patients
Greenbrier VMC LLC Past Accepting new patients

Locations

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

1000 Medical Center Dr
Hardeeville, SC 29927
Phone (843) 784-8138

25 Hospital Ctr
Hilton Head Island, SC 29926
Phone (843) 682-2345

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

1606 Kanawha Blvd W
Charleston, WV 25387
Phone (304) 768-8523

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1265 Maplewood Ave
Lewisburg, WV 24901
Phone (304) 645-2700

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

40823 Midland Trl E
Wht Sphr Spgs, WV 24986
Phone (304) 536-4870

Organizations & group practices 12

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.

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1114040516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 HERLONG AVE S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "803-329-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 HERLONG AVE S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "803-329-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Matthews Township Pkwy",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281054656",
            "country_code": "US",
            "telephone_number": "704-384-9740",
            "fax_number": "704-384-9565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "22580",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "61999",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "22580",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2025-03462",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011979",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.