Active NPI
Candice B Ryan, PTA
- Physical Therapy Assistant
- Ardmore, OK
National Provider Identifier
1720198690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1400
- Practice address
- 1202 Merrick Dr
Ardmore, OK 73401-1824 - Phone
- (580) 226-6754
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1400 | OK | Primary |
Addresses
Primary practice location
1202 Merrick Dr
Ardmore, OK 73401-1824
Mailing address
1202 Merrick Drive
Ardmore, OK 73401
Phone (580) 226-6754
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1400 | Other | OK | LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1400 | OK | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1720198690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 MERRICK DRIVE",
"city": "ARDMORE",
"state": "OK",
"postal_code": "73401",
"telephone_number": "580-226-6754",
"fax_number": "580-226-0394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 MERRICK DR",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734011824",
"telephone_number": "580-226-6754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "CANDICE",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "1400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "1400",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.