Organization Active NPI

Gordon a.Ryan,MD PC

  • Specialist
  • Norfolk, VA
National Provider Identifier
1891970893
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101034688 Issued in VA
Legal business name
GORDON A.RYAN,MD PC
Practice address
400 Gresham Dr
Suite 411
Norfolk, VA 23507-1901
Phone
(757) 624-9433
Fax
(757) 624-6884
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Authorized official

Name
Mrs. Mildred R Cole, RMA
Title
Office MGR.
Phone
(757) 624-9433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 0101034688 VA Primary

Addresses

Primary practice location

400 Gresham Dr
Suite 411
Norfolk, VA 23507-1901

Mailing address

400 Gresham Dr
Suite 411
Norfolk, VA 23507-1901
Phone (757) 624-9433

Other identifiers 1

IdentifierTypeStateIssuer
005878900MedicaidVA

National Provider Directory

National Provider Directory

Locations

400 Gresham Dr
Ste 411
Norfolk, VA 23507
Phone (757) 624-9433

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1891970893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GRESHAM DR",
            "address_2": "SUITE 411",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071901",
            "telephone_number": "757-624-9433",
            "fax_number": "757-624-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GRESHAM DR",
            "address_2": "SUITE 411",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071901",
            "telephone_number": "757-624-9433",
            "fax_number": "757-624-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON A.RYAN,MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "757-624-9433",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RMA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101034688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005878900",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.