Individual provider Active NPI

Ryan Southworth, DO

  • Emergency Medicine Physician
  • Casa Grande, AZ
National Provider Identifier
1386806669
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
005891 Issued in AZ
Practice address
1800 E. Florence Blvd
Casa Grande, AZ 85122
Phone
(610) 776-4622
Fax
(610) 776-4622
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 005891 AZ Primary

Addresses

Primary practice location

1800 E. Florence Blvd
Casa Grande, AZ 85122

Mailing address

1800 E Florence Blvd
Casa Grande, AZ 85122-5303
Phone (530) 902-3709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120515000381 AZ Practitioner - Emergency Medicine 4486812716 Reassigns benefits to 1 organization
I20200302000147 TX Practitioner - Emergency Medicine 4486812716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gila River Health Care CorporationGroup PAC ID 0648174185, 245 clinicians

Practice addresses (Care Compare)

483 W Seed Farm Rd
Hu Hu Kam Memorial Hosp
Sacaton, AZ 85147-0038
Phone (602) 528-1200

Hospital & facility affiliations

  • Huhu Kam Memorial Hospital Hospital, Sacaton, AZ, CCN 031308

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005891AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation Current Accepting new patients
Emergency Physicians Southwest, PC Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Ton Sells Hospital CurrentSince Jan 7, 2020 Accepting new patients
Gila River Health Care Corporation CurrentSince Mar 22, 2020 Accepting new patients
Gila River Health Care CurrentSince Mar 22, 2020 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Ton Sells Hospital Past Accepting new patients

Locations

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

17487 S Healthcare Dr
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1386806669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E FLORENCE BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225303",
            "telephone_number": "530-902-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E. FLORENCE BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85122",
            "telephone_number": "610-776-4622",
            "fax_number": "610-776-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWORTH",
        "first_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "005891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.