Active NPI
Ryan David Egan
- Psychologist
- Durham, NC
National Provider Identifier
1578111407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6726
- Practice address
- 1415 W North Carolina 54
Suite 124
Durham, NC 27707 - Phone
- (919) 214-9664
- Fax
- (984) 287-7886
- NPI assigned
- Sep 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY10565 | FL | |
| Psychologist | 103T00000X | 6726 | NC | Primary |
Addresses
Primary practice location
1415 W North Carolina 54
Suite 124
Durham, NC 27707
Mailing address
3600 N. Duke St. Ste 1
#1450
Durham, NC 27704
Phone (919) 214-9664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 263965524 | Other | FL | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY10565 | FL | MD | Psychologist |
| 6726 | NC | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778371200000",
"number": "1578111407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 N. DUKE ST. STE 1",
"address_2": "#1450",
"city": "DURHAM",
"state": "NC",
"postal_code": "27704",
"telephone_number": "919-214-9664",
"fax_number": "984-287-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 W NORTH CAROLINA 54",
"address_2": "SUITE 124",
"city": "DURHAM",
"state": "NC",
"postal_code": "27707",
"telephone_number": "919-214-9664",
"fax_number": "984-287-7886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGAN",
"first_name": "RYAN",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-04",
"last_updated": "2026-05-10",
"certification_date": "2026-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY10565",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "6726",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "263965524",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.