Active NPI
Mary T. Ryan, M.S., R.D.
- Clinical Social Worker
- Jackson, WY
National Provider Identifier
1427268952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 800
- Practice address
- 535 Cache Creek Dr
Jackson, WY 83001-8653 - Phone
- (307) 690-5785
- NPI assigned
- May 23, 2007
- Last updated
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 800 | WY | Primary |
| Registered Dietitian | 133V00000X | 886773 | WY |
Addresses
Primary practice location
535 Cache Creek Dr
Jackson, WY 83001-8653
Mailing address
PO Box 1076
Jackson, WY 83001-1076
Phone (073) 690-5785
Other practice location 1
610 W Broadway Ave
Jackson, WY 83001-8213
Phone (307) 733-3908
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116673500 | Medicaid | WY |
Other names 1
- Ms. Mary T. Howley
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 800 | WY | MD | Mental Health Counselor |
| 886773 | WY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1427268952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1076",
"city": "JACKSON",
"state": "WY",
"postal_code": "830011076",
"telephone_number": "073-690-5785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 CACHE CREEK DR",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018653",
"telephone_number": "307-690-5785"
}
],
"practiceLocations": [
{
"address_1": "610 W Broadway Ave",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "WY",
"postal_code": "830018213",
"country_code": "US",
"telephone_number": "307-733-3908",
"fax_number": "307-734-0017",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RYAN",
"first_name": "MARY",
"middle_name": "T.",
"name_prefix": "Mrs.",
"credential": "M.S., R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WY",
"license": "800",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WY",
"license": "886773",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116673500",
"state": "WY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "HOWLEY",
"middle_name": "T.",
"prefix": "MS.",
"credential": "MS, RD, PCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.