Organization Active NPI

Ryan M McNett OD LLC

  • Optometrist
  • Derby, KS
National Provider Identifier
1730291469
Registry record updated Jul 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1748 Issued in KS
Legal business name
RYAN M MCNETT OD LLC
Practice address
2020 N Nelson Dr
Suite a
Derby, KS 67037-2572
Phone
(316) 788-1180
Fax
(316) 788-7426
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2012

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

Authorized official

Name
Dr. Ryan Michael McNett, ODNPI 1346379088
Title
Optometrist
Phone
(316) 788-1180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1748 KS Primary

Addresses

Primary practice location

2020 N Nelson Dr
Suite a
Derby, KS 67037-2572

Mailing address

2020 N Nelson Dr
Suite a
Derby, KS 67037-2572
Phone (316) 788-1180

Other identifiers 1

IdentifierTypeStateIssuer
200551760AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070402000705 KS Part B Supplier - Clinic/Group Practice 7113021080 Receives reassigned benefits from 1 practitioner
Practice locations: Derby, KS

National Provider Directory

National Provider Directory

Locations

2020 N Nelson Dr
Ste A
Derby, KS 67037
Phone (316) 788-1180

7700 E Kellogg Dr
#1481
Wichita, KS 67207
Phone (316) 618-4800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342224000000",
    "number": "1730291469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N NELSON DR",
            "address_2": "SUITE A",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372572",
            "telephone_number": "316-788-1180",
            "fax_number": "316-788-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N NELSON DR",
            "address_2": "SUITE A",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372572",
            "telephone_number": "316-788-1180",
            "fax_number": "316-788-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN M MCNETT OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-07-14",
        "status": "A",
        "authorized_official_last_name": "MCNETT",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "316-788-1180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200551760A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2012; 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.