Individual provider Active NPI

Jennifer Ryan

  • Clinical Social Worker
  • Elkridge, MD
National Provider Identifier
1902481997
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21735 Issued in MD
Practice address
6655 Santa Barbara Rd Unit 8574
Elkridge, MD 21075-7523
Phone
(540) 687-0316
NPI assigned
Mar 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21735 MD Primary

Addresses

Primary practice location

6655 Santa Barbara Rd Unit 8574
Elkridge, MD 21075-7523

Mailing address

6655 Santa Barbara Rd Unit 8574
Elkridge, MD 21075-7523
Phone (540) 687-0316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA, GA, MI, KY5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20240111003566 MD Practitioner - Clinical Social Worker 5395196547 Reassigns benefits to 2 organizations
I20240620001718 VA Practitioner - Clinical Social Worker 5395196547 Reassigns benefits to 1 organization
I20240723004199 GA Practitioner - Clinical Social Worker 5395196547 Reassigns benefits to 1 organization
I20241204001127 MI Practitioner - Clinical Social Worker 5395196547 Reassigns benefits to 1 organization
I20250324003365 KY Practitioner - Clinical Social Worker 5395196547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Backpack Medical Group, P.C. Clinical CurrentSince Nov 8, 2023 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients
Linnel Inc PastSince Sep 5, 2023 Accepting new patients

Locations

191 Peachtree St NE
Ste 1400
Atlanta, GA 30303

424 Lewis Hargett Cir
Fl 2
Lexington, KY 40503
Phone (859) 285-6485

1453 N Rolling Rd
Catonsville, MD 21228
Phone (410) 455-5461

6655 Santa Barbara Rd
Unit 8574
Elkridge, MD 21075
Phone (301) 569-2227

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1902481997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 SANTA BARBARA RD UNIT 8574",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757523",
            "telephone_number": "540-687-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 SANTA BARBARA RD UNIT 8574",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757523",
            "telephone_number": "540-687-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "21735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.