Individual provider Active NPI

Ryan G. McNabb, PA

  • Physician Assistant
  • Athens, TN
National Provider Identifier
1184823064
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1514 Issued in TN
Practice address
1114 W Madison Ave
Athens, TN 37303-4150
Phone
(423) 745-1411
Fax
(865) 539-8008
NPI assigned
Jul 12, 2007
Last updated
Nov 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1514 TN Primary

Addresses

Primary practice location

1114 W Madison Ave
Athens, TN 37303-4150

Mailing address

PO Box 634760
Cincinnati, OH 45263-0001

Other identifiers 1

IdentifierTypeStateIssuer
4159770OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000620 TN Practitioner - Physician Assistant 2860584117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900

403 McBrien Rd
East Ridge, TN 37412-3223
Phone (423) 894-3589

455 Chickamauga Dr
Suite 104
Dayton, TN 37321-4286
Phone (423) 570-0252

4747 Hwy 58
Chattanooga, TN 37416-2231
Phone (423) 834-9400

625 E 12TH St
South Pittsburg, TN 37380-1630
Phone (423) 648-4460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1514TNMDBehavioral Analyst
PA1514TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 16, 2022 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 16, 2022 Accepting new patients
Crossroads Urgent Care PLLC Physician Assistant CurrentSince May 23, 2016 Accepting new patients
Crossroads Urgent Care PLLC Physician Assistant CurrentSince May 23, 2016 Accepting new patients

Locations

2021 Hamilton Place Blvd
Chattanooga, TN 37421
Phone (423) 855-9285

419 N Market St
Ste 100
Chattanooga, TN 37405
Phone (423) 414-3012

4747 Highway 58
Chattanooga, TN 37416
Phone (423) 648-4500

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

2006 Memorial Blvd
Ste 101
Springfield, TN 37172
Phone (615) 380-8411

1802 N Jackson St
Ste 850
Tullahoma, TN 37388
Phone (931) 563-5501

Organizations & group practices 4

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1184823064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634760",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W MADISON AVE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373034150",
            "telephone_number": "423-745-1411",
            "fax_number": "865-539-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNABB",
        "first_name": "RYAN",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4159770",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TN

Sources for this page

Verify at the official NPI Registry.