Active NPI
Kathleen Ryan, PH. D.
- Clinical Psychologist
- Westerville, OH
National Provider Identifier
1699716969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4112
- Practice address
- 3 W Main St Ste 202
Westerville, OH 43081-2195 - Phone
- (614) 895-1555
- Fax
- (844) 441-8763
- NPI assigned
- Jun 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4112 | OH | Primary |
Addresses
Primary practice location
3 W Main St Ste 202
Westerville, OH 43081-2195
Mailing address
3 W Main St Ste 202
Westerville, OH 43081-2195
Phone (614) 895-1555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041005000607 | OH | Practitioner - Clinical Psychologist | 1355300435 | Practice locations: Westerville, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3 W Main St
Suite 202
Westerville, OH 43081-2195
Phone (614) 895-1555
S W Main St
Suite 202
Westerville, OH 43081-2195
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4112 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578873600000",
"number": "1699716969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 W MAIN ST STE 202",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430812195",
"telephone_number": "614-895-1555",
"fax_number": "844-441-8763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 W MAIN ST STE 202",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430812195",
"telephone_number": "614-895-1555",
"fax_number": "844-441-8763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "4112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.