Audrey Ryan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10225 Issued in CT

Practice address

22 Masonic Ave
Wallingford, CT 06492-3048

Phone

(203) 679-6273

NPI assigned

Jun 18, 2015

Last updated

May 21, 2020By 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 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1518348226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048",
            "telephone_number": "203-679-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "AUDREY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "10225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT PRACTICE LICENSE",
            "identifier": "10225",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "masonicare.org",
            "affiliation": "N",
            "address_1": "22 Masonic Ave",
            "city": "Wallingford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064923048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephany Rozsa, PT
• Samantha Ruscillo, MS CCC-SLP
• Amanda Rusczek, FNP-BC
• Cara Russo
• Jennifer Filkins Russo, MD
• Kim Marie Sabino, RD
• Yauss B Safavi, M.D.
• Anace H Said, M.D.
• Javier Salabarria, MD
• Azra Saleem, DDS

• Physical Therapist in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.