Individual provider Active NPI

Terri L Ryan, RD

  • Registered Dietitian
  • Kailua Kona, HI
National Provider Identifier
1558540914
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
75-184 Hualalai Rd Ste 203
Kailua Kona, HI 96740-1719
Phone
(808) 329-9211
Fax
(808) 329-0009
NPI assigned
Nov 1, 2007
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

75-184 Hualalai Rd Ste 203
Kailua Kona, HI 96740-1719

Mailing address

75-6026 Alii Dr Apt 4203
Kailua Kona, HI 96740-4319
Phone (808) 345-6919

Other identifiers 1

IdentifierTypeStateIssuer
AV603ZOtherHIMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000197 HI Practitioner - Registered Dietitian Or Nutrition Professional 5991770281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

75 -377 Hualalai Rd
Kailua Kona, HI 96740-9724
Phone (808) 345-6919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes and Nutrition LLC Dietitian, Registered CurrentSince Apr 23, 2017 Accepting new patients
West Hawaii Community Health Center, Inc. Past Accepting new patients
West Hawaii Community Health Center, Inc. Past Accepting new patients

Locations

280 Ponahawai St
Ste 203
Hilo, HI 96720
Phone (808) 797-3113

75-184 Hualalai Rd
Ste 203
Kailua Kona, HI 96740
Phone (808) 329-9211

75-377 Hualalai Rd
Kailua Kona, HI 96740
Phone (808) 329-9211

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1558540914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-6026 ALII DR APT 4203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967404319",
            "telephone_number": "808-345-6919",
            "fax_number": "808-331-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-184 HUALALAI RD STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401719",
            "telephone_number": "808-329-9211",
            "fax_number": "808-329-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TERRI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AV603Z",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.