Marsha G Ryan, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036061951 Issued in IL

Practice address

1237 E Main St
Ste C1
Carbondale, IL 62901-3148

Phone

(618) 457-2281

Fax

(618) 529-0573

NPI assigned

Oct 5, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1548257322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061105",
            "telephone_number": "618-549-5361",
            "fax_number": "618-529-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 E MAIN ST",
            "address_2": "STE C1",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013148",
            "telephone_number": "618-457-2281",
            "fax_number": "618-529-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARSHA",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036061951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061951",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.