Individual provider Active NPI

Ryan Carlton Mann, D.O.

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1114056652
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO.1145 Issued in AL
Practice address
840 Montclair Rd Ste 317
Birmingham, AL 35213-1944
Phone
(205) 592-5745
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO.1145 AL Primary

Addresses

Primary practice location

840 Montclair Rd Ste 317
Birmingham, AL 35213-1944

Mailing address

4100 River View CV
Vestavia, AL 35243-4704
Phone (205) 807-5665

Other identifiers 1

IdentifierTypeStateIssuer
121100MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20101019000570 AL Practitioner - Internal Medicine 3971796236 Reassigns benefits to 2 organizations
I20191025001365 TN Practitioner - Internal Medicine 3971796236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians

Practice addresses (Care Compare)

742 Middle Creek Rd
Sevierville, TN 37862-5019
Phone (865) 446-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3835TNMDClinical Psychologist
DO.1145ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Sep 16, 2019 Accepting new patients
Hospital Medicine Associates LLC Internal Medicine CurrentSince Apr 9, 2018 Accepting new patients
Vincentian Physician Services LLC Internal Medicine CurrentSince Oct 9, 2011 Accepting new patients
Leconte Medical Center Past Accepting new patients
Baptist Health System, Inc. Internal Medicine PastSince Apr 1, 1996 Accepting new patients
Baptist Health System, Inc. Internal Medicine Past Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

820 W Washington St
Eufaula, AL 36027
Phone (334) 687-5761

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

Organizations & group practices 6

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 4

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1114056652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 RIVER VIEW CV",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352434704",
            "telephone_number": "205-807-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 MONTCLAIR RD STE 317",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131944",
            "telephone_number": "205-592-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "RYAN",
        "middle_name": "CARLTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO.1145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121100",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.