Kenneth C Ryan (NPI# 1003843343, PAC ID# 0042367062) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1003843343 |
| PAC ID by PECOS | 0042367062 |
| Professional Enrollment ID | I20090415000665 |
| Full Name | Kenneth C Ryan |
| Organization Legal Name | ROCKY MOUNTAIN PHYSICIAN GROUP LLC |
| Address |
777 Hospital Way Pocatello ID 83201-5175 |
| Phone Number | 4804219700 |
| Gender | M |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 7911267133 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130028 | PORTNEUF MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 777 Hospital Way, Pocatello, ID 83201-5175 | 4804219700 | ROCKY MOUNTAIN PHYSICIAN GROUP LLC |
| Organization Legal Name | ROCKY MOUNTAIN PHYSICIAN GROUP LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jordon Scott Marshall | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Morgan N Anderson | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Jeremy R Monroe | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Kurtis R Holt | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Douglas G Favor | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Kamilla Gundersen | Nurse Practitioner | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| John Conner | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Curtis C Sandy | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Daniel S Dallon | Emergency Medicine | Rocky Mountain Physician Group LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Street Address |
777 HOSPITAL WAY |
| City | POCATELLO |
| State | ID |
| Zip | 83201-5175 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shawn T Allman | Hospitalist | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| David M Gonzalez | Interventional Cardiology | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Janet Lynn Otto | Cardiac Electrophysiology | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Terrence M Rager | General Surgery | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Kimberly Tverdy | Physician Assistant | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Ignacio Morales Carillo | Internal Medicine | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Makenzi M Gwinn | Qualified Audiologist | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Jacob S Delarosa | Cardiac Surgery | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Hannah Caulfield | General Practice | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Yolanda Rodriguez Valdivia | Family Medicine | Pocatello Health Services LLC | 777 Hospital Way, Pocatello, ID 83201-5175 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy A Flicker | Physical Therapy | 2839 Margo Ln, Pocatello, ID 83201-1961 | |
| Michael D Lance | Psychiatry | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Kenneth A Cogen | Nephrology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Randall J Skeem | Internal Medicine | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Martha Elizabeth Franz | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| John L Shuss | General Surgery | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Ciara C Christensen | Clinical Psychologist | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Robin L Hall | Nurse Practitioner | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Laurence L Martens | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Terry J Buccambuso | Diagnostic Radiology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Find all physicians in zip 83201 | |||
| City | POCATELLO |
| Zip Code | 83201 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | POCATELLO + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Kenneth C Ryan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.