Active NPI
Ryan Walter Young
- Diagnostic Radiology Physician
- Tulsa, OK
National Provider Identifier
1184294696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 8056
- Practice address
- 744 W 9TH St
Tulsa, OK 74127-9907 - Phone
- (918) 599-1000
- NPI assigned
- Jun 28, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 8056 | OK | Primary |
Addresses
Primary practice location
744 W 9TH St
Tulsa, OK 74127-9907
Mailing address
1430 N Vinita Ave
Tahlequah, OK 74464-6434
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8056 | OK | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715126400000",
"number": "1184294696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 N VINITA AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744646434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 W 9TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741279907",
"telephone_number": "918-599-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "RYAN",
"middle_name": "WALTER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-28",
"last_updated": "2024-05-08",
"certification_date": "2024-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "OK",
"license": "8056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.