Ryan Michael Tullis

Primary specialty

ParamedicTaxonomy code 146L00000X

License

2011906001 Issued in UT

Practice address

2055 N Main St
Tooele, UT 84074-9819

Phone

(435) 841-9651

NPI assigned

Mar 17, 2020

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ryan_tullis@quorumhealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2020.

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1992331334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749819",
            "telephone_number": "435-841-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIS",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "UT",
            "license": "2011906001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ryan_Tullis@QuorumHealth.com",
            "affiliation": "N",
            "address_1": "2055 N Main St",
            "city": "Tooele",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840749819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Tooele, UT
• Paramedic in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.