Randy Lynn Ryan, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6390681-2501 Issued in UT

Practice address

8823 S Redwood Rd
Suite B Basement
West Jordan, UT 84088-9281

Phone

(801) 913-0098

Fax

(801) 272-3857

NPI assigned

Jan 4, 2010

Sex

Female

Sole proprietor

No

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

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Intermountain Psychology LLC

  • Adult Mental Health Clinic/Center
  • Ogden, UT
  • NPI 1174852289
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1578893129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17586",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841170586",
            "telephone_number": "801-913-0098",
            "fax_number": "801-272-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8823 S REDWOOD RD",
            "address_2": "SUITE B BASEMENT",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889281",
            "telephone_number": "801-913-0098",
            "fax_number": "801-272-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "RANDY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "6390681-2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000068519",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Rust
• RX.Co Pharmacy, LLC
• Ryan Gilbert, M.D., P.C.
• Ryan K Anderson D P M P C
• Ryan M Murphy, Inc.
• Renel B Rytting, APRN
• Adyleen Sa
• Safe Start Group Home LLC
• Anthony Gage Safford, LMT
• Kevin Michael Sagers, D.O.

• Clinical Psychologist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.