Individual provider Active NPI

Marion Louise Ryan, CRNP

  • Adult Health Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1578520169
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R058386 Issued in MD
Practice address
1665 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 546-6650
Fax
(410) 546-2656
NPI assigned
Apr 27, 2006
Last updated
Dec 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R058386 MD Primary

Addresses

Primary practice location

1665 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20190114000603 MD Practitioner - Nurse Practitioner 4981678265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R058386MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lansingburgh Family Practice, PC PastSince Apr 1, 2004 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.medent.com/fhir/R4/gwT5767X

Organizations & group practices 1

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1578520169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-546-6650",
            "fax_number": "410-546-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARION",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R058386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.