Amanda Ryan

Primary specialty

VA Clinic/CenterTaxonomy code 261QV0200X

License

060491 Issued in NY

Practice address

2851 University Ave
Green Bay, WI 54311-5855

Phone

(716) 440-4117

NPI assigned

Jul 7, 2015

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1114300332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 PROMENADE LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211924",
            "telephone_number": "716-440-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 UNIVERSITY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115855",
            "telephone_number": "716-440-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NY",
            "license": "060491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE PHARMACIST LICENSE NUMBER",
            "identifier": "060491",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Russell, LCSW
• Jennifer Ann Russell, DDS
• David J Ruta, MD
• Gabrielle Arline Rutherford
• Lexana Rutz, LPC-IT
• Matthew L Ryan, M.D.
• Michael K Ryan, M.D.
• Judith Ann Rybicki, L.AC.
• Jenna Ryczek, BCBA
• Susan Darlene Rymer

• VA Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• VA Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.