Individual provider Active NPI

Ryan Edward Russi-Myers, FNP

  • Family Nurse Practitioner
  • Laramie, WY
National Provider Identifier
1295348167
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
48439 Issued in WY
Practice address
3114 Willett Dr
Laramie, WY 82072
Phone
(307) 755-4540
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
Yes

Organizations & group practices 6

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group LLC (39 clinicians)
Ivinson Memorial Hospital (61 clinicians)

Practice addresses (Care Compare)

255 N 30TH St
Laramie, WY 82072-5140
Phone (307) 742-2141

Hospital & facility affiliations

  • Ivinson Memorial Hospital Hospital · Laramie, WY · CCN 530025

Merit-based Incentive Payment System (MIPS)

Final score
85.68 of 100 (group)
Quality
75.73
Promoting interoperability
100
Improvement activities
40
Cost
76.55

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20211008002705 WY Practitioner - Nurse Practitioner 6204234040 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
48439WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, LLC Current
since Sep 1, 2021
Accepting new patients
Ivinson Memorial Hospital Current
since Oct 25, 2021
Accepting new patients
Ivinson Memorial Hospital Current
since Oct 25, 2021
Accepting new patients
Ivinson Memorial Hospital Past Accepting new patients

Locations

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 48439 WY Primary

Addresses

NPPES NPI Registry

Primary practice location

3114 Willett Dr
Laramie, WY 82072

Mailing address

1412 S 17TH St Apt C
Laramie, WY 82070-4493

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2023.

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1295348167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 S 17TH ST APT C",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820704493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 WILLETT DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "82072",
            "telephone_number": "307-755-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSI-MYERS",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "48439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.