Andrea Elise Ryan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TC417 Issued in KY

Practice address

3999 Dutchmans Lane
Suite 6F
Louisville, KY 40207-4929

Phone

(502) 394-5678

Fax

(502) 394-5600

NPI assigned

Aug 18, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Community Medical Associates, Inc.

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1467818450
  NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Norton Hospitals, Inc

  • Pain Medicine Physician
  • Louisville, KY
  • NPI 1548152242
  NPD
• Commission for Children With Special Health Car

  • Public Health or Welfare Agency
  • Louisville, KY
  • NPI 1831197953
  NPD (past)

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1194030817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-629-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LANE",
            "address_2": "SUITE 6F",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074929",
            "telephone_number": "502-394-5678",
            "fax_number": "502-394-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ANDREA",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA2023",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMP LICENSE",
            "identifier": "TC417",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acarpentier92330@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3999 Dutchmans Lane",
            "address_2": "Suite 6F",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "3999 Dutchmans Lane",
            "address_2": "Suite 6F",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• RXC Acquisition Company
• Lisa Ryals
• Ryan M Alpino PLLC
• Aimee Michelle Ryan, PT
• Alan Cody Ryan, DNP, MA, APRN, FNP
• Brendan Ryan, MS, LPP, BCBA
• Hannah Ryan, PT, DPT
• Maureen A Ryan, MD
• Nicholas Aaron Ryan, MD
• Nicole Ruth Ryan, RN, DNP, PMHNP-BC

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.