Active NPI
Kevin F Ryan, PA-C
- Adult Health Nurse Practitioner
- Pittsfield, MA
National Provider Identifier
1881886026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 575
- Practice address
- 165 Tor CT
Pittsfield, MA 01201-3001 - Phone
- (413) 447-2000
- Fax
- (413) 447-2176
- NPI assigned
- Aug 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 575 | MA | Primary |
Addresses
Primary practice location
165 Tor CT
Pittsfield, MA 01201-3001
Mailing address
725 North St
Pittsfield, MA 01201-4109
Phone (413) 447-2650
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 575 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1881886026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 NORTH ST",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012014109",
"telephone_number": "413-447-2650",
"fax_number": "413-447-2176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 TOR CT",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012013001",
"telephone_number": "413-447-2000",
"fax_number": "413-447-2176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "KEVIN",
"middle_name": "F",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-13",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.