Individual provider Active NPI

Christopher J Ryan, CAA

  • Anesthesiologist Assistant
  • Saint Louis, MO
National Provider Identifier
1821877978
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
2024020859 Issued in MO
Practice address
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone
(314) 525-1000
NPI assigned
Sep 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2024020859 MO Primary

Addresses

Primary practice location

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Mailing address

PO Box 22407
Saint Louis, MO 63126-0407
Phone (636) 386-7222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240618003999 MO Practitioner - Anesthesiology Assistant 5496298473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Univ of Missouri-Kansas City School of Dentistry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South County Anesthesia Associates LTDGroup PAC ID 4082510383, 81 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1000

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024020859MOMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South County Anesthesia Associates, LTD. CurrentSince Jun 21, 2024 Accepting new patients
South County Anesthesia Associates, LTD CurrentSince Jun 21, 2024 Accepting new patients

Locations

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1821877978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22407",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631260407",
            "telephone_number": "636-386-7222",
            "fax_number": "636-386-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2024020859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.