Active NPI
Jay Ryan
- Physical Therapist
- Lawrence, KS
National Provider Identifier
1417337189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-05063
- Practice address
- 1311 Wakarusa Dr
Lawrence, KS 66049-4798 - Phone
- (785) 749-1300
- NPI assigned
- Jun 8, 2015
- Last updated
- Jun 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-05063 | KS | Primary |
Addresses
Primary practice location
1311 Wakarusa Dr
Lawrence, KS 66049-4798
Mailing address
8813 W 77TH St
Overland Park, KS 66204-2528
Phone (471) 209-5437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-05063 | KS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1417337189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8813 W 77TH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662042528",
"telephone_number": "471-209-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 WAKARUSA DR",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660494798",
"telephone_number": "785-749-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "JAY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-08",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-05063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.