Ryan Novatny, MED, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2018019009 Issued in MO

Practice address

1001 Rogers St
Columbia, MO 65216-0001

Phone

(573) 875-7407

NPI assigned

Aug 1, 2018

Reactivated

Sep 30, 2020

Last updated

Jul 31, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1639657794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROGERS ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652160001",
            "telephone_number": "573-875-7407",
            "fax_number": "573-875-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ROGERS ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652160001",
            "telephone_number": "573-875-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVATNY",
        "first_name": "RYAN",
        "credential": "MED, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "deactivation_date": "2020-06-17",
        "reactivation_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2018019009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Paul North, M.D.
• Mollie Northern, DDS
• Nathan Northup, MO/HIS
• Keith Norman Norton, M.D.
• Nova Health Medical Group, LLC
• Lauren Marie Nowakowski, MD
• Kerri Nowell, PH.D
• Rebecca Ann Nowlin, M.ED.
• Clayton W Nuelle, M.D.
• Julia Ann Vetter Nuelle, M.D.

• Athletic Trainer in Columbia, MO
• Providers in Columbia, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.