Kathryn Elizabeth Ryan-Peterkin, B.S., D.D.S., M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN19375 Issued in FL

Practice address

9250 Baymeadows Rd
Suite 300
Jacksonville, FL 32256-1883

Phone

(904) 731-2120

Fax

(904) 731-9235

NPI assigned

Jun 17, 2011

Last updated

Jul 19, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Science

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Nidal S Elias DDS PA

  • Dental Clinic/Center
  • Jacksonville, FL
  • NPI 1477845865
  NPD (past)

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1386939387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14177 MAHOGANY AVE.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32258",
            "telephone_number": "414-581-4440",
            "fax_number": "904-731-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 BAYMEADOWS RD",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561883",
            "telephone_number": "904-731-2120",
            "fax_number": "904-731-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN-PETERKIN",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "B.S., D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN19375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Ruvoli
• Jean-Christophe N Rwigema, MD, MPH
• RX Solutions Pharmacy LLC (Coastal RX LLC)
• Rxpert Community Pharmacy
• Ryan Pharmacy LLC
• Brendan Thomas Ryan, PHARMD
• Cade Ryan, LCSW
• Corinne Marie Ryan, APRN
• Emily Ryan
• Jennifer Ryan

• Prosthodontics in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.