Individual provider Active NPI

Ryan Randolph Wynn, APRN

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1467195024
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN269330 Issued in GA
Practice address
SC House Calls Inc/Ga House Calls Inc
3312 Northside Drive Building D Suite #200
Macon, GA 31210
Phone
(800) 491-0909
NPI assigned
Apr 20, 2022
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN269330 GA Primary

Addresses

Primary practice location

SC House Calls Inc/Ga House Calls Inc
3312 Northside Drive Building D Suite #200
Macon, GA 31210

Mailing address

SC House Calls Inc
111 Doctors Circle
Columbia, SC 29203
Phone (800) 491-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220722002671 GA Practitioner - Nurse Practitioner 0446631394 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

624 Ellis St
Augusta, GA 30901-1434
Phone (800) 491-0909

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnect Health, Inc. CurrentSince Jul 15, 2022 Accepting new patients
SC House Calls Inc CurrentSince Jun 19, 2023 Accepting new patients
SC House Calls Inc CurrentSince Jun 19, 2023 Accepting new patients
Careconnect Health, Inc. CurrentSince Jul 15, 2022 Accepting new patients

Locations

1109 Medical Center Dr
Ste 2A
Augusta, GA 30909
Phone (706) 901-4242

209 N Camellia Blvd
Fort Valley, GA 31030
Phone (478) 822-0054

2565 Thompson Bridge Rd
Ste 114
Gainesville, GA 30501

125 1st St
Ste C
Macon, GA 31201

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: ryan.wynn.1@7602.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1467195024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SC HOUSE CALLS INC",
            "address_2": "111 DOCTORS CIRCLE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SC HOUSE CALLS INC/GA HOUSE CALLS INC",
            "address_2": "3312 NORTHSIDE DRIVE BUILDING D SUITE #200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31210",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "RYAN",
        "middle_name": "RANDOLPH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-20",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN269330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.