Angela Pearl Ryan, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810007948 Issued in VA

Practice address

43 Ryarbor Dr
Palm Coast, FL 32164-3416

Phone

(904) 206-7701

NPI assigned

Oct 24, 2022

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

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1609593458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 RYARBOR DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321643416",
            "telephone_number": "904-206-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 RYARBOR DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321643416",
            "telephone_number": "904-206-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 Forest Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232263792",
            "country_code": "US",
            "telephone_number": "804-207-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ANGELA",
        "middle_name": "PEARL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rural Therapy Services of Florida Inc
• Kayla A Rusin
• John Michael Russell, M.D.
• Elvis Scott Rutledge, RN
• Nargiz Ruzmetova
• S & B Kingdom Care L.L.C
• S and S United 'LLC'
• S S Marathe MD PA
• Saam Enterprise Inc
• Sacred Hands at Home, LLC

• Clinical Psychologist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.