Kevin Patrick Ryan, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1111 W North 12TH St
Shelbyville, IL 62565-9554

Phone

(217) 774-2111

Fax

(217) 774-9616

NPI assigned

Dec 8, 2010

Last updated

Nov 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midwest PCW PT, LLC

  dba ApexNetwork Physical Therapy

  • Physical Therapist
  • Forsyth, IL
  • NPI 1275931156
  Medicare reassignment NPD
• Dolly Briscoe Enterprises, Inc.

  dba Physician's Choice Wellness

  • Health Educator
  • Mt Zion, IL
  • NPI 1447555685
  NPD (past)
• Vandalia Physical Therapy LTD

  dba Transforming Physical Therapy

  • Physical Therapy Clinic/Center
  • Vandalia, IL
  • NPI 1174585384

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1326341645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 KIRK DR",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491612",
            "telephone_number": "217-433-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W NORTH 12TH ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625659554",
            "telephone_number": "217-774-2111",
            "fax_number": "217-774-9616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "849 S Route 51 Ste D",
            "address_purpose": "LOCATION",
            "city": "Forsyth",
            "state": "IL",
            "postal_code": "625358808",
            "country_code": "US",
            "telephone_number": "217-872-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-08",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "070017064",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald J. Zidek
• Lori Rothrock
• RX Stores LLC (Sav Mor Family Drug Pharmacy)
• RX Stores LLC (Family Drug LTC)
• RX Stores LLC (Family Drug Pharmacy)
• Caleb Rybolt
• Jessica R Schumacher, OTR/L
• Alicia Shain
• Shelby Area Ambulance Service
• Shelby County Community Service Inc

• Physical Therapist in Shelbyville, IL
• Providers in Shelbyville, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.