Individual provider Active NPI

Tara Ryan

  • Clinical Social Worker
  • Fort Worth, TX
National Provider Identifier
1922950948
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62109 Issued in TX
Practice address
4236 Little Bend CT
Fort Worth, TX 76244-5737
Phone
(817) 808-1272
NPI assigned
Feb 11, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 62109 TX Primary

Addresses

Primary practice location

4236 Little Bend CT
Fort Worth, TX 76244-5737

Mailing address

4236 Little Bend CT
Fort Worth, TX 76244-5737
Phone (817) 808-1272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260313003173 TX Practitioner - Clinical Social Worker 3678056900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1700 Covemeadow Dr
Arlington, TX 76012-5407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62109TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond the Gray Sky LLC CurrentSince Feb 4, 2026 Accepting new patients

Organizations & group practices 1

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": "1770768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1922950948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4236 LITTLE BEND CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445737",
            "telephone_number": "817-808-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4236 LITTLE BEND CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445737",
            "telephone_number": "817-808-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.