Physician Compare National (NPI:1801857206)

HEALTHCARE PROVIDER: MARY ELAINE RYAN DNP

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

Individual Professional Information
NPI	1801857206
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7012048895
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100622000749
	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	MARY
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PRIME HEALTHCARE KANSAS CITY - PHYSICIAN SERVICES LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7315267325
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	67
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	302 SE SALEM ST
	Group Practice or individual's line 1 address
Line 2 Street Address	OAK GROVE MEDICAL CLINIC
	Group Practice or individual's line 2 address
City	OAK GROVE
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	640759299
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8166906566
	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	260085
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOSEPH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	170182
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MENORAH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y