Individual provider Active NPI

Ryan Matthew Bellomy, AGACNP, FNP

  • Family Nurse Practitioner
  • Soddy Daisy, TN
National Provider Identifier
1659998425
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27489 Issued in TN
Practice address
210 Walmart Dr
Soddy Daisy, TN 37379-5022
Phone
(423) 332-6155
NPI assigned
Jun 28, 2020
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 27489 TN
Family Nurse Practitioner 363LF0000X 27489 TN Primary

Addresses

Primary practice location

210 Walmart Dr
Soddy Daisy, TN 37379-5022

Mailing address

210 Walmart Dr
Soddy Daisy, TN 37379-5022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20201027001423 TN Practitioner - Nurse Practitioner 4082024377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 Walmart Dr
Soddy Daisy, TN 37379-5022
Phone (423) 332-6155

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
27489TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation Inc CurrentSince Apr 1, 2026 Accepting new patients
Memorial Health Partners Foundation, Inc CurrentSince Apr 1, 2026 Accepting new patients

Locations

210 Walmart Dr
Soddy Daisy, TN 37379
Phone (423) 332-6155

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659998425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WALMART DR",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373795022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WALMART DR",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373795022",
            "telephone_number": "423-332-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLOMY",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "credential": "AGACNP, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-28",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "27489",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

Verify at the official NPI Registry.