Individual provider Active NPI

Ryan Derek Lampe, PT/ATC

  • Physical Therapist
  • Breese, IL
National Provider Identifier
1437174885
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070014296 Issued in IL
Practice address
560 N 2ND St
Breese, IL 62230-1650
Phone
(618) 526-7801
Fax
(618) 526-7901
NPI assigned
Jul 13, 2006
Last updated
Sep 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070014296 IL Primary

Addresses

Primary practice location

560 N 2ND St
Breese, IL 62230-1650

Mailing address

15 Apex Dr
Highland, IL 62249-1282
Phone (618) 651-0444

Other identifiers 2

IdentifierTypeStateIssuer
453140OtherILHEALTHLINK
P00248157OtherILRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329001242 IL Practitioner - Physical Therapist in Private Practice 7719933043 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LMT of Illinois LLCGroup PAC ID 3779617949, 4 clinicians
Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians
Apexnetwork Aviston, LLCGroup PAC ID 6305252578, 3 clinicians

Practice addresses (Care Compare)

2323 Old Plank Rd
Suite a
Chester, IL 62233-1153
Phone (618) 826-2949

538 Mason Dr
Breese, IL 62230-1115
Phone (618) 623-0580

820 Steel Bridge St
Aviston, IL 62216-4403
Phone (618) 574-1824

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Sep 3, 2012 Accepting new patients
Apexnetwork Aviston, LLC Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince Sep 3, 2012 Accepting new patients
LMT of Illinois, LLC Physical Therapist CurrentSince Mar 1, 2010 Accepting new patients
Apex Physical Therapy Physical Therapist Past Accepting new patients
Apex Physical Therapy, LLC. Past Accepting new patients

Locations

820 Steel Bridge St
Aviston, IL 62216
Phone (618) 574-1824

1350 Grand Ave
Beardstown, IL 62618
Phone (217) 350-0361

538 Mason Dr
Breese, IL 62230
Phone (618) 623-0580

560 N 2nd St
Breese, IL 62230
Phone (618) 526-7801

2323 Old Plank Rd
#A
Chester, IL 62233
Phone (618) 826-2949

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

Organizations & group practices 6

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1437174885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282",
            "telephone_number": "618-651-0444",
            "fax_number": "618-654-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N 2ND ST",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622301650",
            "telephone_number": "618-526-7801",
            "fax_number": "618-526-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPE",
        "first_name": "RYAN",
        "middle_name": "DEREK",
        "credential": "PT/ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "453140",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00248157",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breese, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.