Ryan D Toliver, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2006009296 Issued in MO

Practice address

545 Branson Landing Blvd
Ste 306
Branson, MO 65616

Phone

(417) 336-9728

Fax

(417) 337-9710

NPI assigned

Oct 2, 2006

Last updated

Dec 29, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198886400000",
    "number": "1275627606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD",
            "address_2": "STE 306",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-336-9728",
            "fax_number": "417-337-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD",
            "address_2": "STE 306",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-336-9728",
            "fax_number": "417-337-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLIVER",
        "first_name": "RYAN",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2006009296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00390693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "115799",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26576",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "190995",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Duncan Tillack, DO
• Clayton Alexzander Tindell, DO
• Alexandra Titus, OTD
• Wyatt Dawson Titus, DPT
• Bonnie M Todd, FNP
• TP Branson Ops LLC (Total Point Urgent Care)
• Hoa Thi Mai Tran
• Transformed Psychiatric Wellness LLC
• Tri Lakes Medical and Surgical Eye Clinic, Inc. (Tri Lakes Eye Center)
• Tri-Lakes Anesthesia, LLC

• Physician Assistant in Branson, MO
• Providers in Branson, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2007; 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.