Active NPI
Ryan Carl Tronbak, O.T.
- Occupational Therapist
- Bowling Green, KY
National Provider Identifier
1649348277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01548
- Practice address
- 165 Natchez Trace Ave
Suite 200
Bowling Green, KY 42103-7940 - Phone
- (270) 796-4698
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 01548 | IA | Primary |
Addresses
Primary practice location
165 Natchez Trace Ave
Suite 200
Bowling Green, KY 42103-7940
Mailing address
1536 Trillium LN
Bowling Green, KY 42104-5514
Phone (515) 368-2958
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01548 | IA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257206400000",
"number": "1649348277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1536 TRILLIUM LN",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421045514",
"telephone_number": "515-368-2958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 NATCHEZ TRACE AVE",
"address_2": "SUITE 200",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037940",
"telephone_number": "270-796-4698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRONBAK",
"first_name": "RYAN",
"middle_name": "CARL",
"name_prefix": "Mr.",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2009-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "01548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.