Individual provider Active NPI

Chad Ryan

  • Case Manager/Care Coordinator
  • San Diego, CA
National Provider Identifier
1194128090
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4643 Wilson Ave
Apt. 1
San Diego, CA 92116-3582
Phone
(760) 715-3429
NPI assigned
Oct 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

4643 Wilson Ave
Apt. 1
San Diego, CA 92116-3582

Mailing address

4643 Wilson Ave
Apt. 1
San Diego, CA 92116-3582
Phone (760) 715-3429

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

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1194128090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4643 WILSON AVE",
            "address_2": "APT. 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921163582",
            "telephone_number": "760-715-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4643 WILSON AVE",
            "address_2": "APT. 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921163582",
            "telephone_number": "760-715-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.