Individual provider Active NPI

Karlie Anne Ryan

  • Family Nurse Practitioner
  • Northport, AL
National Provider Identifier
1306540380
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-176632 Issued in AL
Practice address
4280 Watermelon Rd Ste 112
Northport, AL 35473-5250
Phone
(205) 750-0030
Fax
(205) 750-0855
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-176632 AL Primary

Addresses

Primary practice location

4280 Watermelon Rd Ste 112
Northport, AL 35473-5250

Mailing address

686 Hampton Hills Dr
Moundville, AL 35474-1928
Phone (205) 331-9913

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231212001890 AL Practitioner - Nurse Practitioner 1850740127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.43 of 100Reported as group
Quality
100
Improvement activities
40
Cost
81.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-176632ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bama Heart Doc, P.C. CurrentSince Aug 5, 2024 Accepting new patients
WV Medical Services PC CurrentSince Dec 1, 2023 Accepting new patients
The Radiology Clinic LLC PastSince Apr 6, 2023 Accepting new patients

Locations

4280 Watermelon Rd
Ste 112
Northport, AL 35473
Phone (205) 464-4975

100 Rice Mine Road Loop
Ste 104
Tuscaloosa, AL 35406
Phone (205) 342-2552

Interoperability endpoints

  • Direct secure messaging: karlieanne.ryan.p1@direct.crd.nextgenshare.com

Organizations & group practices 3

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1306540380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 HAMPTON HILLS DR",
            "city": "MOUNDVILLE",
            "state": "AL",
            "postal_code": "354741928",
            "telephone_number": "205-331-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 WATERMELON RD STE 112",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735250",
            "telephone_number": "205-750-0030",
            "fax_number": "205-750-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KARLIE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-176632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.