Individual provider Active NPI

Ryan Welborn, DO

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1942829965
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-00674 Issued in NC
Practice address
1210 New Garden Rd
Greensboro, NC 27410-2721
Phone
(336) 294-6190
NPI assigned
Apr 9, 2020
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023-00674 NC Primary

Addresses

Primary practice location

1210 New Garden Rd
Greensboro, NC 27410-2721

Mailing address

1210 New Garden Rd
Greensboro, NC 27410-2721
Phone (336) 294-6190

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ryan.Welborn@eaglep.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714002808 NC Practitioner - Family Practice 5294195756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1210 New Garden Rd
Greensboro, NC 27410-2721
Phone (336) 294-6190

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2023-00674NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physicians and Associates PA Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Aug 1, 2023 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

324 W Wendover Ave
Ste 200
Greensboro, NC 27408
Phone (336) 274-6515

Interoperability endpoints

  • Direct secure messaging: ryan.welborn@eaglep.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1942829965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721",
            "telephone_number": "336-294-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721",
            "telephone_number": "336-294-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-00674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ryan.Welborn@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1210 New Garden Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.