Individual provider Active NPI

Ryan Michael Laplace, M.D.

  • General Practice Physician
  • Fort Wainwright, AK
National Provider Identifier
1568870418
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
NE-28863 Issued in NE
Practice address
4076 Neely Road
Fort Wainwright, AK 99703
Phone
(907) 361-5893
NPI assigned
Jul 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NE-28863 NE Primary

Addresses

Primary practice location

4076 Neely Road
Fort Wainwright, AK 99703

Mailing address

4076 Neely Road
Fort Wainwright, AK 99703
Phone (907) 361-5893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240319002098 TX Practitioner - General Practice 0648617282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group PLLCGroup PAC ID 0446296818, 189 clinicians
Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians

Practice addresses (Care Compare)

215 Chisholm TRL
Jacksboro, TX 76458-1403
Phone (940) 567-6633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NE-28863NEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Jan 5, 2024 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

215 Chisholm Trl
Jacksboro, TX 76458
Phone (940) 567-5528

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Organizations & group practices 2

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 8

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1568870418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAPLACE",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "NE-28863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wainwright, AK

Sources for this page

Verify at the official NPI Registry.