Individual provider Active NPI

Casey Ryan, BS, MA

  • Case Manager/Care Coordinator
  • Waterford, MI
National Provider Identifier
1518476977
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
279 Summit Dr
Waterford, MI 48328-3364
Phone
(800) 615-0411
NPI assigned
Sep 28, 2017
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Counselor 101Y00000X CO
Social Worker 104100000X NU
Case Manager/Care Coordinator 171M00000X MI Primary

Addresses

Primary practice location

279 Summit Dr
Waterford, MI 48328-3364

Mailing address

6964 Pebble Park Cir
West Bloomfield, MI 48322-3510
Phone (303) 242-2052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6964 Pebble Park Cir
West Bloomfield, MI 48322-3510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1518476977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6964 PEBBLE PARK CIR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223510",
            "telephone_number": "303-242-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SUMMIT DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283364",
            "telephone_number": "800-615-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CASEY",
        "name_prefix": "Mr.",
        "credential": "BS, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.