Michael Timothy Ryan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT17770 Issued in FL

Practice address

801 S Florida Ave Ste 5
Lakeland, FL 33801-5242

Phone

(863) 688-1800

Fax

(863) 688-1824

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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.

• Leading Edge Physical Therapy & Sports, Inc.

  • Physical Therapist
  • Lakeland, FL
  • NPI 1003903261
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1164510418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S FLORIDA AVE STE 5",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015242",
            "telephone_number": "863-688-1800",
            "fax_number": "863-688-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S FLORIDA AVE STE 5",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015242",
            "telephone_number": "863-688-1800",
            "fax_number": "863-688-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR #",
            "identifier": "P00088453",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT STATE LICENSE #",
            "identifier": "PT17770",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "Y7549",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "611414091",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113534600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rutledge, SLP
• Jack Lee Ryals Jr., PT
• Michael James Ryan Torres, MD
• Carol E Ryan, RMHCI
• Delta Ryan, PA
• Robin Deann Ryan, APRN
• Elizabeth Joan Ryerkerk
• Danielle Marie Rylott, APRN, NP-C
• Terry L Rzepkowski, PT
• S. Matthew Schacht DDS, PA

• All providers in Lakeland, FL
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.