Bonnie Bass Ryan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 03470 Issued in TX

Practice address

2106 North Raguet Street
Nacogdoches, TX 75962-4437

Phone

(936) 468-4008

Fax

(936) 468-1316

NPI assigned

Jun 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Angelina County & Cities Health District

  • Family Medicine Physician
  • Lufkin, TX
  • NPI 1205878022
  NPD (past)
• Epilepsy Foundation of Texas

  • Neuroscience Clinical Nurse Specialist
  • Houston, TX
  • NPI 1306225636
  NPD (past)
• Stephen F. Austin State Univ. Health Service

  • Student Health Clinic/Center
  • Nacogdoches, TX
  • NPI 1265501076
  NPD (past)
• Stephen F. Austin State University

  dba SFASU Student Health

  • Student Health Clinic/Center
  • Nacogdoches, TX
  • NPI 1114361250
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1922035179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512",
            "city": "ETOILE",
            "state": "TX",
            "postal_code": "759440512",
            "telephone_number": "936-465-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 NORTH RAGUET STREET",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759624437",
            "telephone_number": "936-468-4008",
            "fax_number": "936-468-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "BONNIE",
        "middle_name": "BASS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03470",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03470",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA 03470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PA LICENSE NUMBER",
            "identifier": "PA03470",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salena Rothenberger
• Kira Rubin, ATC
• Don Paul Rudasill, O.D.
• Melanie G Rushing, O.D.
• Peni Jean Russell
• Irma M Sainz, MD
• Gerardo Saldana Jr., O.D.
• Sannya Salim, PHARMD
• Samaritan Counseling Center of East TX, Inc
• Hollie Sammons, M.S., CCC-SLP

• Physician Assistant in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.