Physician Compare National (NPI:1558312009)

HEALTHCARE PROVIDER: TIMOTHY E RYAN D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1558312009
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375636160
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070910001040
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RYAN
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	EDWARD
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL PRACTICE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL PRACTICE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	108 N MURRAY HILL RD
	Group Practice or individual's line 1 address
City	COLUMBUS
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	432281524
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6148787407
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RIVERSIDE METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360152
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DOCTORS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360035
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MOUNT CARMEL WEST
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	360189
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MADISON COUNTY HOSPITAL INC
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y