Individual provider Active NPI

Ryann Jean Bubac

  • Physical Therapy Assistant
  • Raleigh, NC
National Provider Identifier
1184856213
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3742 Issued in NC
Practice address
10703 Bedfordtown Dr
Raleigh, NC 27614-7443
Phone
(919) 264-2807
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3742 NC Primary

Addresses

Primary practice location

10703 Bedfordtown Dr
Raleigh, NC 27614-7443

Mailing address

10703 Bedfordtown Dr
Raleigh, NC 27614-7443
Phone (919) 264-2807

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

LicenseStateTypeSpecialty
3742NCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1184856213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10703 BEDFORDTOWN DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147443",
            "telephone_number": "919-264-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10703 BEDFORDTOWN DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147443",
            "telephone_number": "919-264-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBAC",
        "first_name": "RYANN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.