Individual provider Active NPI

Ryan Mathew Kervin

  • Psychiatry Physician
  • Newnan, GA
National Provider Identifier
1144800731
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
110145 Issued in GA
Practice address
59 Hospital Rd
Newnan, GA 30263-1209
Phone
(678) 423-4610
NPI assigned
Apr 9, 2021
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 110145 GA Primary

Addresses

Primary practice location

59 Hospital Rd
Newnan, GA 30263-1209

Mailing address

1055 Beacon Pkwy E Apt C
Birmingham, AL 35209-3245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20260302003641 GA Practitioner - Psychiatry 6204236144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Alabama School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

122 Gordon Commercial Dr
Lagrange, GA 30240-5754
Phone (678) 854-2150

153 Independence Dr
Carrollton, GA 30116-9000
Phone (678) 854-2150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110145GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Center for Behavioral and Developmental Growth CurrentSince Jan 10, 2026 Accepting new patients
Pathways Center for Behavioral and Developmental Growth CurrentSince Jan 10, 2026 Accepting new patients

Locations

59 Hospital Rd
Newnan, GA 30263
Phone (678) 423-4610

Organizations & group practices 2

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.

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": "1765238400000",
    "number": "1144800731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 BEACON PKWY E APT C",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352093245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631209",
            "telephone_number": "678-423-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERVIN",
        "first_name": "RYAN",
        "middle_name": "MATHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "110145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.