Kellie Maria Ryan

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

148 Warren St
Ei So Bay Mental Health
Lowell, MA 01852

Phone

(978) 452-1736

Fax

(978) 452-6625

NPI assigned

Dec 14, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• South Bay Mental Health Center

  • Community/Behavioral Health Agency
  • Lowell, MA
  • NPI 1790092088
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972665362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 PLEASANT ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-851-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WARREN ST",
            "address_2": "EI SO BAY MENTAL HEALTH",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01852",
            "telephone_number": "978-452-1736",
            "fax_number": "978-452-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KELLIE",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine L Russian, OD
• Lisa Ann Russo Anzalone, LMHC
• Jennifer Russo
• Deborah Ryan
• Katharine M Ryan, MSW, LSW, LADC
• Kelly Ann Ryan
• Otajia Sabat
• Marguerite Sabatino, COTA/L
• Carla Sabbouh, MSN, APRN, FNP-C
• Richard A Sachs, MD

• Student in an Organized Health Care Education/Training Program in Lowell, MA
• Providers in Lowell, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• 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.