Ryan Edgar

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12259957 Issued in IN

Practice address

1316 W Dragoon TRL
Mishawaka, IN 46544-4713

Phone

(574) 855-4292

Fax

(574) 635-3201

NPI assigned

Jun 21, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Journeys Behavior Learning Center LLC

  • Developmental Disabilities Clinic/Center
  • Mishawaka, IN
  • NPI 1467924324
  NPD

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1144951237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 W DRAGOON TRL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444713",
            "telephone_number": "574-855-4292",
            "fax_number": "574-635-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 W DRAGOON TRL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465444713",
            "telephone_number": "574-855-4292",
            "fax_number": "574-635-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGAR",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "12259957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradford John Eaton, PH.D.
• Brian D Eberhart, DDS
• Christopher John Eberle, DPM
• Karleisha Echols, RBT
• Stephen Conlon Eder, M.D.
• Penny Edgerly
• Caitlin Elspeth Edward, FNP-BC
• Chad Robert Edwards, PH.D.
• Morgan K Eichorst, PHD
• Amanda Einselen, LMHC

• Behavior Analyst in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.