Lawrence R Ryan, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2014 Issued in AZ

Practice address

6677 W. Thunderbird Road
C-142
Glendale, AZ 85306-3760

Phone

(623) 247-1081

Fax

(623) 247-2962

NPI assigned

Jun 8, 2006

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 AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1366482929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41908",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850801908",
            "telephone_number": "602-973-3100",
            "fax_number": "602-973-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W. THUNDERBIRD ROAD",
            "address_2": "C-142",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063760",
            "telephone_number": "623-247-1081",
            "fax_number": "623-247-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "LAWRENCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263814",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Rutt-Shepard, M.S., CCC-SLP, OTR L
• Rva Surgical Inc
• Ryan Marriage and Family Relationship Therapist, LLC
• Amy Rose Ryan, OTR-L
• Candace Lynn Ryan, PAC
• Patricia M. Ryan, CCC-S
• Patti Ryan, LMFT
• Britiani Richelle Ryder
• Brianna Ryff, OD
• Alexis Ryon, PHARMD BCACP

• Family Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.