Ryan Averett DPM PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

P177 Issued in ID

Legal business name

RYAN AVERETT DPM PC

Practice address

2221 W Ironwood Center Dr
Coeur D Alene, ID 83814-2697

Phone

(208) 667-3585

Fax

(855) 864-8364

NPI assigned

Jun 8, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Kenneth Averett, D.P.M.NPI 1629065610

Title

President

Phone

(208) 661-0295

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Kenneth Averett, D.P.M.

  • Podiatrist
  • Coeur d'Alene, ID
  • NPI 1629065610
  Medicare reassignment Authorized official
• Christopher Butler, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Coeur d'Alene, ID
  • NPI 1659590677
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679514186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 N 4TH ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838143217",
            "telephone_number": "208-667-3585",
            "fax_number": "208-666-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142697",
            "telephone_number": "208-667-3585",
            "fax_number": "855-864-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN AVERETT DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AVERETT",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-661-0295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke T Rushton, CBRS
• Douglas William Rusnack, MD
• Suzanne Jenkins Russell, LCSW CCM
• Alanna Caitlin Russo, NP
• Alison Lee Ruygrok, DPT
• Mary Whitney Ryan, PHD
• Tanya Ryan, LCSW
• Thomas P Ryan, NP
• Aaron Sadowsky
• David Marshal Saelens, MPT

• Foot & Ankle Surgery Podiatrist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.