Ryan Petty, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704289644 Issued in MI

Practice address

6379 Silver Lake Rd
Linden, MI 48451-8706

Phone

(810) 735-7847

Fax

(810) 735-7159

NPI assigned

Apr 21, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpetty1144447@direct.hfhs.org
• Direct secure messaging: ryanpetty@pmi.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Medical Group Genesys

  • Family Medicine Physician
  • Burton, MI
  • NPI 1598248718
  Medicare reassignment Care Compare group NPD
• Henry Ford Medical Group Genesys

  • Family Medicine Physician
  • Mount Morris, MI
  • NPI 1003398470
  NPD
• Henry Ford Medical Group Genesys

  dba Ascension Genesys Ambulatory Therapy

  • Physical Therapist
  • Burton, MI
  • NPI 1114495793
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902331598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6379 SILVER LAKE RD",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518706",
            "telephone_number": "810-735-7847",
            "fax_number": "810-735-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "RYAN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704289644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902331598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra O'Dell
• On Point Services Inc
• P&T Loving Family Care LLC
• Patricia McGarry
• Peaceful Dreams Healing
• Kristin Swanson Polk, MACCC-SLP
• Positively Pediatrics PLLC
• Katrina Faye Prain, ND, CNHP, CHS
• Timothy Garrett Purman, MD
• Ashley Pyrc

• Family Nurse Practitioner in Linden, MI
• Providers in Linden, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.