Ryan Costello, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

E-11969 Issued in AR

Practice address

225 E Jackson Ave
Jonesboro, AR 72401-3119

Phone

(870) 972-4100

NPI assigned

Mar 24, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, TN, MS3 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 3

Specialty

Internal Medicine

Education

Lincoln Memorial University Medical Department, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ryancostello@sbpc.medalliesdirect.net

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  MS

  Medicare reassignment Care Compare group NPD
• St Bernards Hospital Inc

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1336150374
  Medicare reassignment NPD
• St Bernards Hospital Inc.

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1396053096
  Medicare reassignment NPD
• St Bernards Physician Clinics Inc

  • Surgery Physician
  • Jonesboro, AR
  • NPI 1447923438
  NPD
• Baptist Memorial Medical Group Inc

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD

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

• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1396107751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "901-227-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-972-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Exeter Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-757-1350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8040 Wolf River Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381773",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8138 Country Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380162029",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7736 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715306",
            "country_code": "US",
            "telephone_number": "662-772-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "32754",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "4623",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-11969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Corcoran
• Summer Lee Corker, MHPP
• Cornerstone Caregiving East LLC
• Corrie Jones PLLC
• Liam Costello
• Caitlin Rae Cothern, RD
• Amber Cothran, LPC
• Apryll Nunnally Cottingham, CRC, LPC
• Jonathan P Cottingham, APRN
• Greg Couch

• Internal Medicine Physician in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Internal Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.