Individual provider Active NPI

Ryan Thomas Scanlon

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1609752203
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
611 S Jefferson St Apt 1010
Roanoke, VA 24011-2443
Phone
(703) 867-0998
NPI assigned
Aug 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

611 S Jefferson St Apt 1010
Roanoke, VA 24011-2443

Mailing address

611 S Jefferson St Apt 1010
Roanoke, VA 24011-2443
Phone (703) 867-0998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260605001246 NC Practitioner - Physician Assistant 4486125994

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Zotec Way
Carmel, IN 46032-0052

26239 Rachel Hill Dr
South Riding, VA 20152-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1609752203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S JEFFERSON ST APT 1010",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240112443",
            "telephone_number": "703-867-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S JEFFERSON ST APT 1010",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240112443",
            "telephone_number": "703-867-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "RYAN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.