Individual provider Active NPI

Timothy Dennis Ryan, PT

  • Physical Therapist
  • Hobbs, NM
National Provider Identifier
1467449744
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
561 Issued in NM
Practice address
3830 N Grimes St
Suite B
Hobbs, NM 88240-1279
Phone
(575) 392-3971
Fax
(575) 392-4169
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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 561 NM Primary

Addresses

Primary practice location

3830 N Grimes St
Suite B
Hobbs, NM 88240-1279

Mailing address

3830 N Grimes St
Suite B
Hobbs, NM 88240-1279
Phone (575) 392-3971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100702000454 NM Practitioner - Physical Therapist in Private Practice 7214935089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Saint Louis University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3830 N Grimes St
Suite B
Hobbs, NM 88240-1279
Phone (575) 392-3971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
561NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Hobbs Orthopaedic & Sports Therapy PC CurrentSince Jul 17, 1989 Accepting new patients

Locations

3830 N Grimes St
Ste B
Hobbs, NM 88240
Phone (505) 392-3971

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1467449744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 N GRIMES ST",
            "address_2": "SUITE B",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882401279",
            "telephone_number": "575-392-3971",
            "fax_number": "575-392-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 N GRIMES ST",
            "address_2": "SUITE B",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882401279",
            "telephone_number": "575-392-3971",
            "fax_number": "575-392-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TIMOTHY",
        "middle_name": "DENNIS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobbs, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.