Individual provider Active NPI

Ryan Eubanks

  • Certified Registered Nurse Anesthetist
  • Leesburg, GA
National Provider Identifier
1679949200
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN198478 Issued in GA
Practice address
115 Apalachee Dr
Leesburg, GA 31763-5214
Phone
(229) 869-7708
NPI assigned
Aug 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN198478 GA Primary

Addresses

Primary practice location

115 Apalachee Dr
Leesburg, GA 31763-5214

Mailing address

115 Apalachee Dr
Leesburg, GA 31763-5214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023000104 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698084150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

151 Mayo St
Suite B
Americus, GA 31709-4782
Phone (229) 928-2900

151 Mayo St a
Americus, GA 31709-4782
Phone (229) 312-5800

151 Mayo St C
Americus, GA 31709-4782
Phone (229) 928-2882

151 Mayo St D
Americus, GA 31709-4782
Phone (229) 928-1100

151 Mayo St E
Americus, GA 31709-4782
Phone (229) 931-1159

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-5222

Hospital & facility affiliations

  • Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN198478GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Oct 7, 2015 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Nov 1, 2023 Accepting new patients
Tift Regional Health System Inc. CurrentSince Oct 7, 2015 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1679949200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 APALACHEE DR",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 APALACHEE DR",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635214",
            "telephone_number": "229-869-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN198478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.