Individual provider Active NPI

Ryan Powell

  • Emergency Medicine Physician
  • Lebanon, OR
National Provider Identifier
1255837688
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO214750 Issued in OR
Practice address
200 Mullins Dr
Lebanon, OR 97355-3983
Phone
(541) 259-0200
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO214750 OR Primary

Addresses

Primary practice location

200 Mullins Dr
Lebanon, OR 97355-3983

Mailing address

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230816001181 OR Practitioner - Emergency Medicine 7214359066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Emergency Room Corp PCGroup PAC ID 2668467317, 20 clinicians

Practice addresses (Care Compare)

1460 G St
Springfield, OR 97477-4112
Phone (541) 726-4400

Hospital & facility affiliations

  • McKenzie-Willamette Medical Center Hospital, Springfield, OR, CCN 380020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO214750ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Emergency Room Corp PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Western University of Health Sciences Past Accepting new patients

Locations

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1804/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rpowell1426393@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1255837688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "541-259-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "541-259-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-10-17",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO214750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.