Individual provider Active NPI

Robert Ryan, ATR, LMHC

  • Mental Health Counselor
  • Gulfport, FL
National Provider Identifier
1972932267
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16795 Issued in FL
Practice address
5001 23Rd Ave S
Gulfport, FL 33707-5103
Phone
(773) 273-8800
NPI assigned
Nov 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH16795 FL Primary

Addresses

Primary practice location

5001 23Rd Ave S
Gulfport, FL 33707-5103

Mailing address

5001 23Rd Ave S
Gulfport, FL 33707-5103
Phone (773) 273-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204003647 FL Practitioner - Mental Health Counselor 9638527476 Practice locations: Gulfport, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5001 23Rd Ave S
Gulfport, FL 33707-5103
Phone (773) 273-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1972932267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 23RD AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337075103",
            "telephone_number": "773-273-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 23RD AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337075103",
            "telephone_number": "773-273-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ROBERT",
        "credential": "ATR, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, FL

Sources for this page

Verify at the official NPI Registry.