Individual provider Active NPI

Ryan Avery, MD

  • Student in an Organized Health Care Education/Training Program
  • Mobile, AL
National Provider Identifier
1306409594
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341
Phone
(251) 432-4117
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341

Mailing address

1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341
Phone (251) 432-4117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230421002163 AL Practitioner - Pediatric Medicine 9638534845 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Primary Health Center Inc. CurrentSince Dec 8, 2022 Accepting new patients
Franklin Primary Health Center, Inc CurrentSince Dec 8, 2022 Accepting new patients

Locations

1303 Dr Martin L King Jr Ave
Mobile, AL 36603
Phone (251) 436-7646

1303 Dr Martin L King Jr Ave
#A
Mobile, AL 36603

424 S Wilson Ave
Prichard, AL 36610
Phone (251) 452-1442

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1306409594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 DR MARTIN L KING JR AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035341",
            "telephone_number": "251-432-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 DR MARTIN L KING JR AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366035341",
            "telephone_number": "251-432-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.