Kaeli Ann Ryan, PT, DPT, LAT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P23204 Issued in NC

Practice address

9020 Senca Dr
Wilmington, NC 28411-6679

Phone

(910) 264-9317

NPI assigned

Jun 3, 2024

Sex

Female

Sole proprietor

No

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 NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Eastern Therapy Solutions, PLLC

  • Occupational Therapist
  • Wilmington, NC
  • NPI 1073143343

  Physical Therapist

  Medicare reassignment NPD
• Wilmington Eye, P.a.

  • Optician
  • Wilmington, NC
  • NPI 1962566893
  NPD (past)

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1841031192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 SENCA DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284116679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 SENCA DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284116679",
            "telephone_number": "910-264-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KAELI",
        "middle_name": "ANN",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-5362",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Russo, RDN
• Jerry Page Rutledge, LCSW
• Brandi Elizabeth Ryan, LMT
• Brandon Ryan, PA-C, NREMT-P
• David Michael Ryan, NP
• Karen Zaytoun Ryan, LCSW
• Kathleen Riley Ryan, DO
• Rebecca Sue Ryan, MS/CCC-SLP
• Tara Lynne Ryan, LCASA
• S. Terry Withers, Jr., M.D.

• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.