Individual provider Active NPI

Ryan Ranells, FNP-BC

  • Family Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1275279226
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN312953 Issued in GA
Practice address
1605 Roberta Dr SW
Marietta, GA 30008-3855
Phone
(559) 930-8504
NPI assigned
May 11, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN312953 GA Primary

Addresses

Primary practice location

1605 Roberta Dr SW
Marietta, GA 30008-3855

Mailing address

1605 Roberta Dr SW
Marietta, GA 30008-3855
Phone (770) 419-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220820000314 GA Practitioner - Nurse Practitioner 2567840721 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Health Center of Cobb Current Accepting new patients
Good Samaritan Health Center of Cobb CurrentSince Aug 1, 2022 Accepting new patients

Locations

1605 Roberta Dr SW
Marietta, GA 30008
Phone (770) 419-3120

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, 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": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1275279226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "770-419-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "559-930-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANELLS",
        "first_name": "RYAN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-09-09",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN312953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.