MR. RYAN JACK MARTIN (NPI# 1124163894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124163894 |
| Entity Type | Individual |
| Full Name | MR. RYAN JACK MARTIN |
| Credential | PAC |
| Practice Address |
8440 Walnut Hill Ln Ste 610 Dallas TX 75231-3815 |
| Practice Telephone | 2143456000 |
| Practice Fax Number | 2143456026 |
| Mailing Telephone | 2143456000 |
| Mailing Fax Number | 2143456026 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2019-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA03455 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA03455 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | STATE LICENSE | PA03455 | 01 |
| TX | 281283603 | 05 | |
| TX | 281283601 | 05 | |
| TX | 281283602 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588032205 | Ryan Kyle Martin | Physical Therapist | 10 Canalview Mall Ste C, Fulton, NY 13069-1769 | 2015-09-11 |
| 1124265053 | Ryan Andrew Martin | Counselor | 1401 S Waldron Rd Ste 200, Fort Smith, AR 72903-2590 | 2009-01-14 |
| 1780708388 | Ryan Martin | Physical Therapist | 63-17 Metropolitan Avenue, Middle Village, NY 11379 | 2007-03-19 |
| 1407457815 | Ryan Martin | Pharmacist | 1111 Hayes Ave, Sandusky, OH 44870-3323 | 2020-11-03 |
| 1366080947 | Ryan Martin | Dietitian, Registered | 41 Burlington Mall Rd, Burlington, MA 01805-0001 | 2019-12-14 |
| 1922654284 | Ryan Martin | Pharmacist | 788 W Pike St, Clarksburg, WV 26301-2649 | 2019-08-13 |
| 1093299737 | Ryan Martin | Physician Assistant | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2018-09-19 |
| 1285173591 | Ryan James Martin | Internal Medicine | 5001 Hardy St, Hattiesburg, MS 39402-1308 | 2017-02-20 |
| 1659734580 | Ryan Christopher Martin | Emergency Medicine | 1001 Potrero Ave, San Francisco, CA 94110-3518 | 2016-03-29 |
| 1457711780 | Ryan Kevin Martin | Internal Medicine | 5100 W Broad St, Columbus, OH 43228-1607 | 2016-02-29 |
| Street Address |
8440 WALNUT HILL LN STE 610 |
| City | DALLAS |
| State | TX |
| Zip Code | 75231-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306846787 | Byung Ryang Park | Internal Medicine | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2005-07-28 |
| 1568913051 | Elizabeth Annette Rice | Nurse Practitioner | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2016-10-19 |
| 1235523721 | Blair Shackleton Peterson | Physician Assistant | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2015-03-24 |
| 1295158103 | Kaitlin Elizabeth Moore | Physician Assistant | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2014-01-28 |
| 1669893848 | Erin Tenney | Physician Assistant | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2013-12-14 |
| 1689978769 | Shawn Matthew Sommerlad | Physician Assistant | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2011-01-04 |
| 1376704510 | Parin Parikh | Internal Medicine | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2008-06-20 |
| 1639294119 | Charles Victor Lampe | Internal Medicine | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2007-03-21 |
| 1669579835 | Carter A King | Internal Medicine | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2006-09-20 |
| 1174550834 | David S Harper | Internal Medicine | 8440 Walnut Hill Ln Ste 610, Dallas, TX 75231-3815 | 2006-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987022 | Specialists In Geriatric and Palliative Care Medicine Pllc | Clinic/Center | 8198 Walnut Hill Lane, Jackson Bldg, Suite 100, Dallas, TX 75231 | 2020-09-21 |
| 1013546118 | The Legacy Midtown Park, Inc | Skilled Nursing Facility | 8280 Manderville Lane, Dallas, TX 75231 | 2020-04-02 |
| 1003383373 | Northeast Dallas Dentistry, PC | Dentist | 6401 East Northwest Highway, Suite 100, Dallas, TX 75231 | 2018-10-25 |
| 1518442565 | Daniel Max & Marc Andrea LLC | Optometrist | 6471 E Northwest Hwy, Dallas, TX 75231 | 2018-09-26 |
| 1760964100 | Amber Nicole Caruthers | Nurse Practitioner | 8060 Park Lane, Dallas, TX 75231 | 2018-09-01 |
| 1376024893 | Brittany Leigh Stedman | Physical Therapist | 8130 Meadow Rd, Dallas, TX 75231 | 2018-08-23 |
| 1700367224 | Tia Cornelius | Occupational Therapy Assistant | 8130 Meadow Rd., Dallas, TX 75231 | 2018-08-23 |
| 1538653753 | Manju R. Goyal M.d. Psychiatry Pllc | Psychiatry & Neurology | 5477 Glen Lakes Dr Ste 210, Dallas, TX 75231 | 2018-06-20 |
| 1497246813 | Stacy Jo Thomas | Counselor | 10260 N Central Expy Ste 280, Dallas, TX 75231 | 2018-05-21 |
| 1235626615 | Texas Health Presbyterian Hospital Dallas | Durable Medical Equipment & Medical Supplies | 8160 Walnut Hill Lane, First Floor, Dallas, TX 75231 | 2018-04-20 |
| Find all providers in zip 75231 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| 1225643562 | Yermiahu Levi Sarne | Physician Assistant | 6206 Preston Crest Ln, Dallas, TX 75230-1828 | 2020-09-14 |
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1275151102 | Kelly Ashworth | Physician Assistant | 7331 Gaston Ave # 180, Dallas, TX 75214-4131 | 2020-07-07 |
| 1780201715 | Gabriela Yvonne Camacho | Physician Assistant | 7331 Gaston Ave Unit 180, Dallas, TX 75214-4131 | 2020-06-25 |
| 1346879699 | Ws Neuroassist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-80, Dallas, TX 75214-6126 | 2020-04-07 |
| 1265065122 | Sarah Bell Stewart | Physician Assistant | 7811 Bryn Mawr Dr, Dallas, TX 75225-8217 | 2020-02-19 |
| 1093348237 | Meagan Lee Barry | Physician Assistant | 221 W Colorado Blvd Ste 431, Dallas, TX 75208-2312 | 2020-02-17 |
| 1245863554 | Melissa Ann Johnston | Physician Assistant | 4373 Boca Bay Dr, Dallas, TX 75244-7408 | 2020-02-14 |
| 1205479607 | Mj Surgical, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 906, Dallas, TX 75207-3912 | 2019-10-18 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.