Individual provider Active NPI

Timothy Roy Ryan, APRN

  • Nurse Practitioner
  • Omaha, NE
National Provider Identifier
1427248848
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
110874 Issued in NE
Practice address
988102 Nebraska Medical Center
Omaha, NE 68198-8102
Phone
(402) 559-9800
Fax
(402) 559-7929
NPI assigned
Aug 1, 2007
Last updated
Sep 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 110874 NE Primary

Addresses

Primary practice location

988102 Nebraska Medical Center
Omaha, NE 68198-8102

Mailing address

988102 Nebraska Medical Center
Omaha, NE 68198-8102
Phone (402) 559-9800

Other identifiers 1

IdentifierTypeStateIssuer
10026059800MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070823000240 NE Practitioner - Nurse Practitioner 2769574649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince May 1, 2009 Accepting new patients
Creighton University Past Accepting new patients
Creighton University Past Accepting new patients

Locations

7710 Mercy Rd
Ste 420
Omaha, NE 68124
Phone (402) 393-6700

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-1010

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1427248848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-9800",
            "fax_number": "402-559-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102",
            "telephone_number": "402-559-9800",
            "fax_number": "402-559-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TIMOTHY",
        "middle_name": "ROY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "110874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026059800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.