Ryan McClellan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

55873 Issued in AZ

Practice address

4915 E Baseline Rd Ste 119
Gilbert, AZ 85234-2969

Phone

(480) 832-0480

Fax

(480) 832-0490

NPI assigned

Apr 7, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3484/brand/1/csg/1/fhir/r4

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.

• All-Star Pediatrics, PLLC

  • Pediatrics Physician
  • Gilbert, AZ
  • NPI 1073801056
  NPD (past)

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1588050595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 E BASELINE RD STE 119",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342969",
            "telephone_number": "480-832-0480",
            "fax_number": "480-832-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 E BASELINE RD STE 119",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342969",
            "telephone_number": "480-832-0480",
            "fax_number": "480-832-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "55873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian McCann, FNP
• Emily Elizabeth McCarthy, NP
• Kelly McCaughley
• Casey Allen McClellan, LAMFT
• Robert McClellan, LAC
• Todd McClenaghan, DMD
• Andrea McClimon, LMSW
• Darya McClure, MAS-MFT, LAMFT
• John Edward McClure, PHARMD
• Aubriana McCollough, PT, DPT

• Pediatrics Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.