Lisa Ryan, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1092 Issued in WV

Practice address

31452 Veterans Memorial Hwy
Terra Alta, WV 26764-9715

Phone

(304) 789-1029

NPI assigned

Feb 5, 2016

Last updated

Feb 1, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialty Physicians of Garrett County, LLCGroup PAC ID 5698082436, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Specialty Physicians of Garrett County, LLC

  • Obstetrics & Gynecology Physician
  • Oakland, MD
  • NPI 1265819866
  Medicare reassignment Care Compare group NPD
• Wellspring Family Medicine, PC

  • Family Medicine Physician
  • Oakland, MD
  • NPI 1194744359
  Medicare reassignment
• Specialty Physicians of Garrett County, LLC

  dba Health and Wellness Services of Garrett Regional Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oakland, MD
  • NPI 1871065813
  NPD
• Specialty Physicians of Garrett County, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grantsville, MD
  • NPI 1881361442
  NPD

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1477911428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CATHEDRAL PARK DR",
            "city": "AURORA",
            "state": "WV",
            "postal_code": "267058217",
            "telephone_number": "304-698-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31452 VETERANS MEMORIAL HWY",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267649715",
            "telephone_number": "304-789-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-05",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "1092",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Rodeheaver, LMT
• Roger a Lewis (Cranberry Medical Clinic)
• Gail Rose
• Heather Raynae Rosenberger
• Rylee Roy
• Carla Denell Seigh
• Theresa Shiftlett
• Cassandra Grace Smith
• Jimmy B Smith
• Kimberly Stump

• Clinical Psychologist in Terra Alta, WV
• Providers in Terra Alta, WV by specialty
• Clinical Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.