Individual provider Active NPI

Gwen Mary Van Ryen-Sink, PT/ATC

  • Specialist
  • Mooresville, NC
National Provider Identifier
1235407651
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6449 Issued in NC
Practice address
514 Williamson Rd
Suite 431
Mooresville, NC 28117-9225
Phone
(704) 360-2595
Fax
(704) 360-2596
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 6449 NC Primary

Addresses

Primary practice location

514 Williamson Rd
Suite 431
Mooresville, NC 28117-9225

Mailing address

21221 Baltic Dr
Cornelius, NC 28031-6424
Phone (704) 895-3359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121227000335 NC Practitioner - Physical Therapist in Private Practice 7911150982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K-2 Healthcare ConsultingGroup PAC ID 9335310721, 4 clinicians

Practice addresses (Care Compare)

508 Williamson Rd
Suite 200
Mooresville, NC 28117-9186
Phone (704) 360-2595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6449NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
K-2 Healthcare Consulting CurrentSince Dec 10, 2012 Accepting new patients

Locations

508 Williamson Rd
Ste 200
Mooresville, NC 28117
Phone (704) 360-2595

514 Williamson Rd
Ste 431
Mooresville, NC 28117
Phone (704) 360-2595

Organizations & group practices 1

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": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1235407651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21221 BALTIC DR",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316424",
            "telephone_number": "704-895-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 WILLIAMSON RD",
            "address_2": "SUITE 431",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179225",
            "telephone_number": "704-360-2595",
            "fax_number": "704-360-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN RYEN-SINK",
        "first_name": "GWEN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PT/ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "6449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.