Ryan Jessup O'Leary, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200201293 Issued in NC

Practice address

6401 Stargaze LN
Charlotte, NC 28269-0802

Phone

(704) 591-7196

Fax

(704) 464-1818

NPI assigned

Oct 27, 2006

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1568548154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17104 PENNINGTON DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784854",
            "telephone_number": "704-995-2249",
            "fax_number": "980-689-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 STARGAZE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282690802",
            "telephone_number": "704-591-7196",
            "fax_number": "704-464-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "RYAN",
        "middle_name": "JESSUP",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200201293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89133J6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Harte O'Grady, LCSW
• Madison Taylor O'Hara, OTR/L
• Jennifer Priory O'Keefe, FNP-C
• Kaitlyn Elizabeth O'Keefe, DO
• Megan O'Leary, M.ED., ED.S., LCMHC
• Deirdre O'Malley
• Walter Brian O'Malley, PH.D.
• Kristina Lynn O'Mara, CRNA
• Madison Marie O'Meara, FNP
• Scott Boyd O'Neal, M.D.

• Pediatrics Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.