Active NPI
Ryan Fay
- Nurse Practitioner
- Lafayette, IN
National Provider Identifier
1114386208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71006080A
- Practice address
- 4050 Britt Farm Dr Ste C
Lafayette, IN 47905-0712 - Phone
- (765) 297-0696
- Fax
- (888) 377-6346
- NPI assigned
- Feb 17, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71006080A | IN | Primary |
Addresses
Primary practice location
4050 Britt Farm Dr Ste C
Lafayette, IN 47905-0712
Mailing address
179 W 550 S
Cutler, IN 46920-9307
Phone (937) 570-2448
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kfay@lafayettefamilywellness.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71006080A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flora Family Medicine, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Flora, IN
- NPI 1629499330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1114386208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 W 550 S",
"city": "CUTLER",
"state": "IN",
"postal_code": "469209307",
"telephone_number": "937-570-2448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 BRITT FARM DR STE C",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479050712",
"telephone_number": "765-297-0696",
"fax_number": "888-377-6346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAY",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-17",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71006080A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kfay@lafayettefamilywellness.com",
"affiliation": "N",
"address_1": "4050 Britt Farm Dr Ste C",
"city": "Lafayette",
"state": "IN",
"country_code": "US",
"postal_code": "479050712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.