NPIMap

Individual provider Active NPI

Ryan Vansickle, M.D., PHARMD.

  • Emergency Medicine Physician
  • Berryville, AR
National Provider Identifier
1972872703
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-13914 Issued in AR
Practice address
214 Carter St
Berryville, AR 72616-4303
Phone
(870) 423-3355
NPI assigned
Dec 22, 2011
Last updated
May 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119791 MN
Anesthesiology Physician 207L00000X R-9718 IA
Emergency Medicine Physician 207P00000X E-13914 AR Primary

Addresses

Primary practice location

214 Carter St
Berryville, AR 72616-4303

Mailing address

214 Carter St
Berryville, AR 72616-4303
Phone (870) 423-3355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210512000745 AR Practitioner - Emergency Medicine 9931341104 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1808 W Main St
Russellville, AR 72801-2724
Phone (501) 968-2841

620 N Mail St
Harrison, AR 72601-2911
Phone (870) 414-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
119791MNMDPharmacist
R-9718IAMDAnesthesiology Physician
E-13914ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Health, Inc CurrentSince Oct 1, 2023 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Sep 4, 2025 Accepting new patients
Michael S. Clarke, M.D., P.a. Current Accepting new patients
North Arkansas Regional Medical Center Current Accepting new patients
Mercy Hospital Berryville CurrentSince May 3, 2021 Accepting new patients
Ies Arkansas PLLC Emergency Medicine CurrentSince Nov 1, 2023 Accepting new patients
Eureka Springs Hospital Commission CurrentSince Jan 12, 2026 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Jan 16, 2024 Accepting new patients
North Arkansas Regional Medical Center CurrentSince Jan 16, 2024 Accepting new patients
Ozark Health, Inc CurrentSince Oct 1, 2023 Accepting new patients
Ozark Health, Inc Past Accepting new patients

Locations

214 Carter St
Berryville, AR 72616
Phone (870) 423-3355

2500 Highway 65 S
Clinton, AR 72031
Phone (501) 745-7000

24 Norris St
Eureka Springs, AR 72632
Phone (479) 253-7400

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

620 N Main St
Harrison, AR 72601
Phone (870) 365-2000

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/ozarkh-5b939301

Organizations & group practices 11

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 3

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": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1972872703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CARTER ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164303",
            "telephone_number": "870-423-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CARTER ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164303",
            "telephone_number": "870-423-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSICKLE",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D., PHARMD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "119791",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "R-9718",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-13914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

Verify at the official NPI Registry.