Active NPI
Ryan Hladky, AA
- Anesthesiologist Assistant
- St Joseph, MO
National Provider Identifier
1144727637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 2020009586
- Practice address
- 4510 Frederick Blvd
St Joseph, MO 64506-3238 - Phone
- (816) 364-9992
- Fax
- (816) 364-9996
- NPI assigned
- Apr 10, 2018
- 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 |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 2020009586 | MO | Primary |
Addresses
Primary practice location
4510 Frederick Blvd
St Joseph, MO 64506-3238
Mailing address
PO Box 413739
Kansas City, MO 64141-3739
Phone (717) 263-5562
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16 | OK | MD | Music Therapist |
| 2020009586 | MO | MD | Anesthesiologist Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1144727637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 413739",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641413739",
"telephone_number": "717-263-5562",
"fax_number": "717-263-1566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4510 FREDERICK BLVD",
"city": "ST JOSEPH",
"state": "MO",
"postal_code": "645063238",
"telephone_number": "816-364-9992",
"fax_number": "816-364-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HLADKY",
"first_name": "RYAN",
"name_prefix": "Mr.",
"credential": "AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-10",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "MO",
"license": "2020009586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.