Ryan Harris, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020018086 Issued in MO

Practice address

1055 Bowles Ave Ste 202
Fenton, MO 63026-2308

Phone

(636) 326-7821

Fax

(636) 326-7897

NPI assigned

Feb 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Management Medical Center, LLCGroup PAC ID 4486722410, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pain Management Medical Center, LLC

  • Specialist
  • Florissant, MO
  • NPI 1073784823
  Medicare reassignment Care Compare group NPD
• Restorative Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Florissant, MO
  • NPI 1932719754
  NPD

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

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1285228213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 BOWLES AVE STE 202",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262308",
            "telephone_number": "636-326-7821",
            "fax_number": "636-326-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 BOWLES AVE STE 202",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262308",
            "telephone_number": "636-326-7821",
            "fax_number": "636-326-7897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 Bellevue Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171857",
            "country_code": "US",
            "telephone_number": "314-768-8491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-20",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60944314",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041500644",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2013025076",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022160",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020018086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Hammond, MD
• James Edwin Hanny, MA, MSC. CCC/SLP
• Mansoor Ul Haq, M.D.
• Tiffany Shanta Harold, APRN
• Darrel Alan Harris, R.N.
• Amanda Haury, LPC
• Hawkins Heights Dental
• Christopher M Hawkins, DDS
• Anthony Hayibor
• Lucy Hays

• Family Nurse Practitioner in Fenton, MO
• Providers in Fenton, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.