Ryan Austin Harrell, DO

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2023-02667 Issued in NC

Practice address

6 Doctors Cir Ste 5
Supply, NC 28462-6358

Phone

(910) 721-4370

Fax

(910) 721-4379

NPI assigned

Apr 16, 2013

Last updated

May 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  NPD (past)

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1750724167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "910-721-4370",
            "fax_number": "910-721-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DOCTORS CIR STE 5",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284626358",
            "telephone_number": "910-721-4370",
            "fax_number": "910-721-4379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Howard Farm Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300416081",
            "country_code": "US",
            "telephone_number": "770-292-6500",
            "fax_number": "770-292-6535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "RYAN",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2023-02667",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "92602",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "2023-02667",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "VA",
            "license": "0102205681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Evans Gore, AU.D.
• Charles Daniel Hall, M.D.
• Gina M. Hamilton, MSW, LCSW
• Sabrina Elizabeth Harkey, AUD
• Carla Harper-Martinez, LCSWA
• Hailey Harris
• Dawn Sautters Harrison, FNP
• Robert E Hassler, MD
• Tina Maria Hatch, OTA/L
• Olivia Leigh Hintz, LCSWA

• Orthopaedic Surgery Physician in Supply, NC
• Providers in Supply, NC by specialty
• Orthopaedic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.