Kathleen Christina Ryan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

61451 Issued in GA

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 466-9821

NPI assigned

Apr 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kathleen Christina Flaherty Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1114161957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 CONNELL RD",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347664",
            "telephone_number": "210-665-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-466-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KATHLEEN",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "61451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "FLAHERTY",
            "middle_name": "CHRISTINA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jarel Russell, OTD, OTR/L
• Nichelle Aquino Russell, AGNP-C
• Tyler G Russell, PSY.D.
• Malana Russo, DMD
• Dana C. Rutherford, MSN, FNP
• Kimberly Ryan, MD
• Michael Gene Ryder, DSCPT
• Raubby Sabalerio, D.O.
• Heidi Marie Sabellico, CRNA
• Victor Sabourin

• Family Medicine Physician in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.