Michael G Ryan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200901870 Issued in NC

Practice address

19485 Old Jetton Rd
Suite 100
Cornelius, NC 28031-6582

Phone

(704) 384-1775

Fax

(704) 384-1776

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Novant Medical Group, Inc.

  dba Southeast Children's Urology

  • Pediatric Urology Physician
  • Huntersville, NC
  • NPI 1881707487
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1386679496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602362",
            "telephone_number": "704-384-1775",
            "fax_number": "704-384-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19485 OLD JETTON RD",
            "address_2": "SUITE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316582",
            "telephone_number": "704-384-1775",
            "fax_number": "704-384-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01023417",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200901870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200307000A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000067648",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4255189",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080162612",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "415089P",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64022296",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Thomas Royster
• Lloyd Austin Aaron Runser, MD, MPH, FAAFP
• Shaunna Rushing, LCMHCA
• Marleen Russ
• Sheri Russell, MS, CCC-SLP
• Heather Lucia Rypien, AGPCNP-C
• Safe Home Pro, Inc.
• Safety Harbor Assessment and Therapy Services, PLLC
• Joseph Anthony Saglimbeni II, LCMHC-A, NCC
• Salisbury Pediatric Associates, PA (Touchstone Health Associates)

• Family Medicine Physician in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.