Kathleen M Ryan, PT
Individual provider Active NPI Physical Therapist · Edgefield, SC
NPI 1275939662 · NPPES record last updated Oct 7, 2024
Key facts
- NPI
- 1275939662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3200 (SC)
- Practice address
- 85 Lick Fork Rd
Edgefield, SC 29824-3358 - Phone
- (706) 631-7288
- NPI assigned
- Nov 12, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Functional Pathways Preferred of Tennessee LLC
Practice addresses (Care Compare)
1825 Clifton Rd NE
Atlanta, GA 30329-4047
Phone (888) 531-2204
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241119002532 | GA | Practitioner - Physical Therapist in Private Practice | 7911432695 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP035127T | GA | MD | Physical Therapist |
| 3200 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Functional Pathways Preferred of Tennessee LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1825 Clifton Rd NE
Atlanta, GA 30329
Phone (256) 254-0137
10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3200 | SC | Yes |
| Physical Therapist | 225100000X | CP035127T | GA |
Addresses
Primary practice location
85 Lick Fork Rd
Edgefield, SC 29824-3358
Mailing address
85 Lick Fork Rd
Edgefield, SC 29824-3358
Phone (706) 631-7288
Other practice location 1
1825 Clifton Rd NE
Atlanta, GA 30329-4047
Phone (678) 907-4266
Other providers in Edgefield, SC
- George L Rainsford
- Patricia Rainsford
- Austin N Rampey
- River Road Care
- Julian Thomas Rushin
- David Anthony Sandoval
- SC-Ga2018 the Ridge Rehabilitation and Healthcare Center, LLC
- Self Regional Healthcare Partners
- Self Regional Healthcare Partners
- Self Regional Healthcare Partners
All providers in Edgefield, SC · Physical Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.