Ryan John Supon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0008927 Issued in CO

Practice address

302 3Rd St SE
Loveland, CO 80537-6419

Phone

(970) 669-4855

Fax

(970) 350-4692

NPI assigned

May 14, 2015

Last updated

Mar 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Podiatry

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ryan.supon.1@27043.direct.athenahealth.com

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.

• Sunrise Community Health

  dba Loveland Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1902005382

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Sunrise Community Health

  dba North Loveland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Loveland, CO
  • NPI 1700690252
  NPD
• Sunrise Community Health

  dba Kid's Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Evans, CO
  • NPI 1811295264
  NPD

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1467830083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 3RD ST SE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805376419",
            "telephone_number": "970-669-4855",
            "fax_number": "970-350-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 3RD ST SE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805376419",
            "telephone_number": "970-669-4855",
            "fax_number": "970-350-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPON",
        "first_name": "RYAN",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunrise Community Health (North Loveland Community Health Center)
• Sunrise Community Health (SummitStone Clinic)
• Sunrise Community Health (Loveland Community Health Clinic)
• Sunrise Community Health (Sunrise Thompson Health Clinic)
• Sunshine Therapy LLC
• Support, Inc.
• Surgery Center of Loveland, LLC (Loveland Surgery Center)
• Surgical Assistance
• Jamie Denise Sutton, PHARMD
• Suzanne Golden

• Physician Assistant in Loveland, CO
• Providers in Loveland, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.