Ryan Patrick Macrae, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4031 Issued in SC

Practice address

635 Old Greenville Hwy
Clemson, SC 29631-1219

Phone

(864) 722-9255

NPI assigned

Sep 27, 2006

Last updated

Feb 3, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Ryan P. Macrae, LLC

  dba Mountain Lakes Family Dentstry

  • Dentist
  • Clemson, SC
  • NPI 1124304795
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1407947534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 OLD GREENVILLE HWY",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311219",
            "telephone_number": "864-722-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 OLD GREENVILLE HWY",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311219",
            "telephone_number": "864-722-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACRAE",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "20-1710817",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Littlejohn Community Center
• Jessica Loudermilk, PT DPT
• Trudy Lovejoy, APNP
• Susan Lusk
• Sara Lynch
• Nancy Mahlie, OD
• Thomas Arthur Malone, MD
• Jessica Maloney
• Miranda Martin
• Amy Fletcher Massingill, LPC

• General Practice Dentistry in Clemson, SC
• Providers in Clemson, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.