Active NPI
Michael John Ryan, BA, CADC
- Addiction (Substance Use Disorder) Counselor
- Fort Dodge, IA
National Provider Identifier
1134709694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 21033
- Practice address
- 211 Avenue M W
Fort Dodge, IA 50501-5789 - Phone
- (515) 576-7261
- NPI assigned
- Apr 9, 2021
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 21033 | IA | Primary |
Addresses
Primary practice location
211 Avenue M W
Fort Dodge, IA 50501-5789
Mailing address
211 Avenue M W
Fort Dodge, IA 50501-5789
Phone (515) 576-7261
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
211 Ave M W
Fort Dodge, IA 50501-5789
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21033 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community and Family Resources | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Substance Abuse Rehabilitation Facility
- Fort Dodge, IA
- NPI 1366507790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1134709694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 AVENUE M W",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015789",
"telephone_number": "515-576-7261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 AVENUE M W",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505015789",
"telephone_number": "515-576-7261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"credential": "BA, CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2021-04-09",
"certification_date": "2021-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IA",
"license": "21033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Dodge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.