Individual provider Active NPI

Ryan Patrick Fallon, OT

  • Occupational Therapist
  • Clio, MI
National Provider Identifier
1497296313
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201009713 Issued in MI
Practice address
4282 W Vienna Rd
Clio, MI 48420-9454
Phone
(810) 564-2400
Fax
(810) 564-9994
NPI assigned
Mar 10, 2017
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201009713 MI Primary

Addresses

Primary practice location

4282 W Vienna Rd
Clio, MI 48420-9454

Mailing address

4466 W Bristol Rd
Flint, MI 48507-3170
Phone (810) 733-1200

Other identifiers 1

IdentifierTypeStateIssuer
1497296313MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170331001338 MI Practitioner - Occupational Therapist in Private Practice 5890070916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4466 W Bristol Rd
Flint, MI 48507-3170
Phone (810) 733-1200

Merit-based Incentive Payment System (MIPS)

Final score
68.79 of 100Reported as group
Quality
20.79
Promoting interoperability
94
Improvement activities
40
Cost
80.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Orthopedic Associates P L C Occupational Therapist CurrentSince Mar 13, 2017 Accepting new patients
Family Orthopedic Associates P L C Occupational Therapist CurrentSince Mar 13, 2017 Accepting new patients
Family Orthopedic Associates P L C Occupational Therapist Past Accepting new patients

Locations

4282 W Vienna Rd
Clio, MI 48420
Phone (810) 564-2400

17015 Silver Pkwy
Fenton, MI 48430
Phone (810) 593-0023

4466 W Bristol Rd
Flint, MI 48507
Phone (810) 733-1200

Organizations & group practices 3

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1497296313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073170",
            "telephone_number": "810-733-1200",
            "fax_number": "810-733-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484209454",
            "telephone_number": "810-564-2400",
            "fax_number": "810-564-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497296313",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.