RYAN ELLSWORTH (NPI# 1104130574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104130574 |
| Entity Type | Individual |
| Full Name | RYAN ELLSWORTH |
| Practice Address |
4019 W 12600 S Suite 120 Riverton UT 84096 |
| Mailing Address |
4019 W 12600 S Ste 120 Riverton UT 84096-7405 |
| Practice Telephone | 8012536886 |
| Practice Fax Number | 8012536888 |
| Mailing Telephone | 8012536886 |
| Mailing Fax Number | 8012536888 |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2018-05-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
8400193-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | DME | 7672880001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013447309 | Ryan L Ellsworth | Counselor | 2318 Ne Mlk Jr Blvd, Portland, OR 97212-3715 | 2017-06-19 |
| Street Address |
4019 W 12600 S SUITE 120 |
| City | RIVERTON |
| State | UT |
| Zip Code | 84096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386645398 | Mark R Elkins Dpm PC | Podiatrist | 4019 W 12600 S, Suite 120, Riverton, UT 84096-7302 | 2005-08-02 |
| 1649460668 | Total Vision Care, LLC | Optometrist | 4019 W 12600 S, Suite 110, Riverton, UT 84096-7401 | 2007-07-26 |
| 1376762435 | Alan C Baugh Dmd, PC | Clinic/Center | 4019 W 12600 S, Ste 210, Riverton, UT 84065 | 2007-04-25 |
| 1942376231 | Nathan Daniel Stevenson | Dentist | 4019 W 12600 S, Suite 200, Riverton, UT 84096 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1225563703 | Kristen Haslam | Specialist/Technologist, Other | 13947 S Newburg Dr., Herriman, UT 84096 | 2017-04-21 |
| 1770960452 | Tyler Rolland Petersen | Social Worker | 13351 S Shaunna Lane, Herriman, UT 84096 | 2015-05-01 |
| 1649687948 | Victor Clark | Assisted Living Facility | 6352 W 13100 S, Herriman, UT 84096 | 2014-07-18 |
| 1548539554 | Neck and Back Relief | Chiropractor | 12600 S. 4013 W., Suite E, Riverton, UT 84096 | 2011-12-20 |
| 1114220092 | Sharlene Christensen | Counselor | 13878 S. Ken Cv, Herriman, UT 84096 | 2010-12-14 |
| 1518156991 | Jon Christian Fairbanks | Dentist | 5532 W. Herriman Main Street, #210, Herriman, UT 84096 | 2007-10-22 |
| 1215154232 | Karen Jane Olson | Nurse Practitioner | 13400 S. 5746 W #200, Herriman, UT 84096 | 2007-04-19 |
| 1619022969 | Jeffrey T Lambert | Dentist | 5532 W. Herriman Main St., #210, Herriman, UT 84096 | 2007-01-25 |
| 1578638854 | Stevenson Pediatric Dentistry P.C. | Dentist | 4019 W. 12600 S., Suite 200, Riverton, UT 84096 | 2006-11-21 |
| Find all providers in zip 84096 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942549795 | Ellsworth Foot and Ankle Clinic, LLC | Podiatrist | 12523 S Creek Meadow Rd Ste 105, Riverton, UT 84065 | 2013-02-13 |
| 1366734394 | Kathryn C Decker | Podiatrist | 4019 W 12600 S Ste 120, Riverton, UT 84096-7405 | 2011-05-10 |
| 1912057290 | Aaron Deane Donaldson | Podiatrist | 1005 College View Dr, Riverton, WY 82501-2266 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721303 | Stride Foot and Ankle Pllc | Podiatrist | 1365 W 1250 S Ste 101, Orem, UT 84058-2303 | 2020-08-18 |
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1447773122 | Apex Foot and Ankle Institute | Podiatrist | 882 N Main St # 2, Richfield, UT 84701-1840 | 2017-07-25 |
| 1902328644 | Weston Charles Packard | Podiatrist | 1561 W 7000 S Ste 201, West Jordan, UT 84084-3556 | 2017-07-14 |
| 1053844753 | Elite Ankle and Foot Pllc | Podiatrist | 39 E Center Street, Gunnison, UT 84634 | 2017-04-10 |
| 1811341621 | Victor Kent Myers | Podiatrist | 754 S Main St Ste 3, St George, UT 84770-5505 | 2016-04-18 |
| 1598119463 | Landon Cameron | Podiatrist | 1490 E Foremaster Dr Ste 250, St George, UT 84790-4501 | 2016-04-18 |
| 1417338161 | Adam Bowen Wood | Podiatrist | 1248 E 90 N Ste 101, American Fork, UT 84003-2954 | 2015-06-17 |
| Find all providers with the same taxonomy | ||||
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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.