Stephen Edward Ryan, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6292 Issued in MN

Practice address

530 East Second Street
Duluth, MN 55805

Phone

(218) 786-5360

NPI assigned

Jun 20, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment NPD
• Children'S Health Care

  • Pediatric Cardiology Physician
  • Minneapolis, MN
  • NPI 1841738952
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• Deer River Healthcare Center, Inc.

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1831629047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 E. BIDDLE ST.",
            "address_2": "PATIENT ACCOUNTING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 EAST SECOND STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-5360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051832",
            "country_code": "US",
            "telephone_number": "443-923-2820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "STEPHEN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Day Ryan, PHD, LP
• Kristin Nodgaard Ryan
• Michael Edward Ryan
• Natalie Jo Ryan, MSW, LICSW
• Robert G Ryan, DDS
• Alan Thomas Sabroski, RN
• Katie M Sackett, D.O.
• Marena Saeger
• Elyas David Safar, M.D.
• Deborah E Sah, MD

• Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.