NPIMap

Organization Active NPI

Ryan Macks, LLC

  • Clinical Psychologist
  • Mason, OH
National Provider Identifier
1548501059
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6162 Issued in OH
Legal business name
RYAN MACKS, LLC
Practice address
7577 Central Parke Blvd
Suite 113
Mason, OH 45040-6810
Phone
(513) 204-5746
Fax
(513) 229-3707
NPI assigned
Mar 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Authorized official

Name
Ryan Macks, PH.D.NPI 1588607279
Title
Licensed Clinical Psychologist
Phone
(513) 204-5746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6162 OH Primary

Addresses

Primary practice location

7577 Central Parke Blvd
Suite 113
Mason, OH 45040-6810

Mailing address

7577 Central Parke Blvd
Suite 113
Mason, OH 45040-6810
Phone (513) 204-5746

Other identifiers 3

IdentifierTypeStateIssuer
MACP79161OtherOHMEDICARE
2592725MedicaidOH
0080731MedicaidOH

National Provider Directory

National Provider Directory

Locations

7577 Central Parke Blvd
Ste 113
Mason, OH 45040
Phone (513) 204-5746

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1548501059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7577 CENTRAL PARKE BLVD",
            "address_2": "SUITE 113",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450406810",
            "telephone_number": "513-204-5746",
            "fax_number": "513-229-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7577 CENTRAL PARKE BLVD",
            "address_2": "SUITE 113",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450406810",
            "telephone_number": "513-204-5746",
            "fax_number": "513-229-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN MACKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "MACKS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "513-204-5746",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MACP79161",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2592725",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.