Peggy A Ryan, APRN,BC,ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71000242A Issued in IN

Practice address

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Phone

(260) 483-9081

NPI assigned

Oct 13, 2005

Sex

Female

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 3

Other names 1

• Peggy A Cox Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1962490839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7887 N OLD STATE ROAD 37",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089443",
            "telephone_number": "812-339-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 STELLHORN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154631",
            "telephone_number": "260-483-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "PEGGY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "APRN,BC,ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000242A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "28068822A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "71000242B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "71000242A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "COX",
            "middle_name": "A",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathy L Rutan, MSW
• Steven Ray Rutan, O.D.
• RX Holdings, LLC
• Ryan Beeching Counseling LLC
• Jessica Lee Ryan
• Sayge Ryan, CTRS
• Shirley Ann Ryan, MS, LMHC, LMFTA
• Thomas P Ryan, DO
• Christina Ryder, MS, LAT, ATC
• Benjamin Charles Ryman, PHARMD

• Adult Health Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.