Rickey Olvin Ryals

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

R3273 Issued in AR

Practice address

1 Lile CT
Suite 101
Little Rock, AR 72205-6242

Phone

(501) 225-7711

Fax

(501) 225-7108

NPI assigned

Mar 28, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1639130073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LILE CT",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056242",
            "telephone_number": "501-225-7711",
            "fax_number": "501-225-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LILE CT",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056242",
            "telephone_number": "501-225-7711",
            "fax_number": "501-225-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYALS",
        "first_name": "RICKEY",
        "middle_name": "OLVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "R3273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118659001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Lyman Rutledge, M.D.
• RWW Senior Living Outpatient Rehab Services LLC
• RX Moose Inc
• RX Moose Inc
• David Brent Ryals, M.D.
• Ryan a Moore DDS, PLLC
• Ryan Russ LLC
• Ryan Wood OD PLLC
• Kristin Ryan
• Lauren Ryan, PTA

• Anatomic Pathology & Clinical Pathology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.