Individual provider Active NPI

Penny Lee Ryan, RNFA

  • General Practice Registered Nurse
  • Bryan, TX
National Provider Identifier
1780666016
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
253494 Issued in TX
Practice address
6395 Steep Hollow Cir
Bryan, TX 77808-5127
Phone
(979) 776-0045
Fax
(979) 774-3440
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 253494 TX Primary

Addresses

Primary practice location

6395 Steep Hollow Cir
Bryan, TX 77808-5127

Mailing address

6395 Steep Hollow Cir
Bryan, TX 77808-5127
Phone (979) 776-0045

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

LicenseStateTypeSpecialty
253494TXMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
BCS Surgical Assistants, PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780666016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6395 STEEP HOLLOW CIR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778085127",
            "telephone_number": "979-776-0045",
            "fax_number": "979-774-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6395 STEEP HOLLOW CIR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778085127",
            "telephone_number": "979-776-0045",
            "fax_number": "979-774-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "PENNY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "253494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.