Active NPI
Ryan Hudson Fitzgerald, DPM
- Podiatrist
- Canton, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- POD001364
- Practice address
- 132 Riverstone Ter Ste 101
Canton, GA 30114 - Phone
- (678) 880-0036
- Fax
- (404) 481-4427
- NPI assigned
- May 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 626 | SC | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 0103301013 | VA | |
| Podiatrist | 213E00000X | POD001364 | GA | Primary |
Addresses
Primary practice location
132 Riverstone Ter Ste 101
Canton, GA 30114
Mailing address
900 Circle 75 Pkwy SE Ste 900
Atlanta, GA 30339-3084
Phone (678) 426-2171
Other practice location 1
355 Tower Rd NE Ste 103
Marietta, GA 30060-9410
Phone (770) 590-4188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PD6265 | Medicaid | SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rfitzgerald436535@directwellstar.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Barry University School of Podiatric Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570
2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274
2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900
355 Tower Rd NE
Suite 103
Marietta, GA 30060-9410
Phone (770) 917-6795
4900 Ivey NWRD
Suite 1826
Acworth, GA 30101-4142
Phone (770) 975-9077
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
- Wellstar Cobb Medical Center
- Wellstar Paulding Medical Center
- Wellstar Windy Hill Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 149 |
| Removal or shaving of skin growth | 49 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POD001364 | GA | MD | Podiatrist |
| 0103301013 | VA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616
355 Tower Rd NE
Ste 103
Marietta, GA 30060
Phone (770) 420-1690
Interoperability endpoints
- rfitzgerald@direct-address.org
- rfitzgerald@directaddress.net
- rfitzgerald436535@directwellstar.org
Organizations & group practices 2
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.
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wellstar Cobb Hospital
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
dba Wellstar Kennestone Hospital
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
-
dba Wellstar Windy Hill Hospital
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
-
dba Wellstar Paulding Hospital
- General Acute Care Hospital
- Hiram, GA
- NPI 1457329435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643155200000",
"number": "1760649602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 CIRCLE 75 PKWY SE STE 900",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303393084",
"telephone_number": "678-426-2171",
"fax_number": "404-446-1957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 RIVERSTONE TER STE 101",
"city": "CANTON",
"state": "GA",
"postal_code": "30114",
"telephone_number": "678-880-0036",
"fax_number": "404-481-4427"
}
],
"practiceLocations": [
{
"address_1": "355 Tower Rd NE Ste 103",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300609410",
"country_code": "US",
"telephone_number": "770-590-4188",
"fax_number": "770-590-4189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FITZGERALD",
"first_name": "RYAN",
"middle_name": "HUDSON",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2022-01-26",
"certification_date": "2022-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "SC",
"license": "626",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "VA",
"license": "0103301013",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "GA",
"license": "POD001364",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PD6265",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rfitzgerald436535@directwellstar.org",
"affiliation": "N",
"address_1": "355 Tower Rd NE Ste 103",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300609410",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.