Individual provider Active NPI

Thomas J Ryan, MD

  • Emergency Medicine Physician
  • Oakton, VA
National Provider Identifier
1518956754
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101032143 Issued in VA
Practice address
2961A Hunter Mill Rd # 140
Oakton, VA 22124-1704
Phone
(703) 901-1383
Fax
(703) 255-1091
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101032143 VA Primary

Addresses

Primary practice location

2961A Hunter Mill Rd # 140
Oakton, VA 22124-1704

Mailing address

10330 Hickory Forest Dr
Oakton, VA 22124-1523
Phone (703) 255-3712

Other identifiers 1

IdentifierTypeStateIssuer
006087540MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101032143VAMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1518956754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 HICKORY FOREST DR",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221241523",
            "telephone_number": "703-255-3712",
            "fax_number": "703-255-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961A HUNTER MILL RD # 140",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221241704",
            "telephone_number": "703-901-1383",
            "fax_number": "703-255-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101032143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006087540",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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.