Individual provider Active NPI

Lyndsie Carolyn Ryalls, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Norwich, CT
National Provider Identifier
1679903983
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5609 Issued in CT
Practice address
40 Broadway
Norwich, CT 06360-5702
Phone
(860) 887-6536
Fax
(860) 887-2784
NPI assigned
Nov 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5609 CT Primary

Addresses

Primary practice location

40 Broadway
Norwich, CT 06360-5702

Mailing address

40 Broadway
Norwich, CT 06360-5702
Phone (860) 887-6536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140319001959 CT Practitioner - Nurse Practitioner 8022249812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Stony Creek Wellness Group, LLCGroup PAC ID 3072896380, 5 clinicians

Practice addresses (Care Compare)

264 Church St
Guilford, CT 06437-2439
Phone (203) 693-4566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5609CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Creek Wellness Group, LLC Psychiatric/Mental Health CurrentSince Jan 14, 2017 Accepting new patients
The Griffin Hospital CurrentSince Sep 14, 2015 Accepting new patients
Reliance Health, Inc Past Accepting new patients
Geriatric and Adult Psychiatry, LLC Past Accepting new patients

Locations

130 Division St
Derby, CT 06418
Phone (203) 732-1330

264 Church St
Guilford, CT 06437
Phone 2036934566 ext. 10

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1679903983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BROADWAY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605702",
            "telephone_number": "860-887-6536",
            "fax_number": "860-887-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BROADWAY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605702",
            "telephone_number": "860-887-6536",
            "fax_number": "860-887-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYALLS",
        "first_name": "LYNDSIE",
        "middle_name": "CAROLYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "5609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.