Jeffrey Ryan, PA-C
Individual provider Active NPI Physician Assistant · Pleasant View, UT
NPI 1891774196 · NPPES record last updated Feb 3, 2018
Key facts
- NPI
- 1891774196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 4813150-1206 (UT)
- Practice address
- 1100 W 2700 N
Pleasant View, UT 84404-4791 - Phone
- (801) 475-3600
- Fax
- (801) 475-3601
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050728000824 | UT | Practitioner - Physician Assistant | 8325076656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4813150-1206 | UT | Yes |
Addresses
Primary practice location
1100 W 2700 N
Pleasant View, UT 84404-4791
Mailing address
PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3900
Other providers in Pleasant View, UT
- Regeneration Health of Northern Utah
- Resonant Relating LLC
- Russell Robbins
- Kylie Roberts
- Roe RX Inc
- Scott Whitaker Crna PC
- Kelsey Simmons
- Stephen K Smith
- Chelese Southwick
- Stuart G. Gibby, D.D.S., M.S., P.C.
All providers in Pleasant View, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.