Individual provider Active NPI

J. Thomas Ryan, M.D.

  • Family Medicine Physician
  • Fredericksburg, VA
National Provider Identifier
1790731032
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101024132 Issued in VA
Practice address
120 Executive Center Pkwy
Fredericksburg, VA 22401-3100
Phone
(540) 374-5200
Fax
(540) 374-1164
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101024132 VA Primary

Addresses

Primary practice location

120 Executive Center Pkwy
Fredericksburg, VA 22401-3100

Mailing address

2300 Fall Hill Ave
Suite 215
Fredericksburg, VA 22401-3342
Phone (540) 374-5097

Other identifiers 1

IdentifierTypeStateIssuer
5632862MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790731032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 FALL HILL AVE",
            "address_2": "SUITE 215",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013342",
            "telephone_number": "540-374-5097",
            "fax_number": "540-374-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 EXECUTIVE CENTER PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013100",
            "telephone_number": "540-374-5200",
            "fax_number": "540-374-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "J. THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101024132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5632862",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.