Individual provider Active NPI

Ryan E Neault, ATC

  • Sports Medicine (Emergency Medicine) Physician
  • Anderson, SC
National Provider Identifier
1972633998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
734 Issued in SC
Practice address
316 Boulevard # 999
Anderson, SC 29621-4002
Phone
(864) 231-2144
Fax
(864) 622-6059
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X 734 SC Primary

Addresses

Primary practice location

316 Boulevard # 999
Anderson, SC 29621-4002

Mailing address

316 Boulevard # 999
Anderson, SC 29621-4002
Phone (864) 231-2144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
734SCMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson University Past 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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972633998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 BOULEVARD # 999",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214002",
            "telephone_number": "864-231-2144",
            "fax_number": "864-622-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 BOULEVARD # 999",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214002",
            "telephone_number": "864-231-2144",
            "fax_number": "864-622-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAULT",
        "first_name": "RYAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "SC",
            "license": "734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.