Individual provider Active NPI

Kelly Ryan, APRN, FNP-C

  • Nurse Practitioner
  • Dover, DE
National Provider Identifier
1548963861
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0012296 Issued in DE
Practice address
640 S. State Street
Bayhealth Wound Care Center, 2ND Floor
Dover, DE 19901
Phone
(302) 744-7500
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0012296 DE
Nurse Practitioner 363L00000X LG-0012296 DE Primary

Addresses

Primary practice location

640 S. State Street
Bayhealth Wound Care Center, 2ND Floor
Dover, DE 19901

Mailing address

640 S. State St.
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Other practice location 1

100 Wellness Way
Bayhealth Wound Care Center Sussex Campus
Milford, DE 19963
Phone (302) 744-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230426000994 DE Practitioner - Nurse Practitioner 4385009356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, shared by 16 NPIs, 399 clinicians

Practice addresses (Care Compare)

640 S State St
Dover, DE 19901-3530
Phone (302) 744-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc. Current Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Mar 17, 2023 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Mar 17, 2023 Accepting new patients
Bayhealth Medical Center, Inc. Current Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Mar 17, 2023 Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients

Locations

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

640 S State St
Dover, DE 19901
Phone (302) 744-4700

640 S State St
#2
Dover, DE 19901

640 S State St
Fl 2
Dover, DE 19901
Phone (302) 744-7500

101 Wellness Way
Ste 250
Milford, DE 19963
Phone (302) 744-6220

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1548963861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE ST.",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "BAYHEALTH WOUND CARE CENTER, 2ND FLOOR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19901",
            "telephone_number": "302-744-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Wellness Way",
            "address_2": "Bayhealth Wound Care Center Sussex Campus",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "DE",
            "postal_code": "19963",
            "country_code": "US",
            "telephone_number": "302-744-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KELLY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012296",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0012296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.