DR. RYAN GLENN MIYAMOTO (NPI# 1497923288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497923288 |
| Entity Type | Individual |
| Full Name | DR. RYAN GLENN MIYAMOTO |
| Credential | M.D. |
| Practice Address |
3620 Joseph Siewick Dr Ste 201 Fairfax VA 22033-1758 |
| Practice Telephone | 7033910111 |
| Practice Fax Number | 7033912945 |
| Mailing Telephone | 7033910111 |
| Mailing Fax Number | 7033912945 |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
0101245582 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245415454 | Ryan Keith Miyamoto | Urology | 1717 N E St, 430, Pensacola, FL 32501-6339 | 2008-01-07 |
| Street Address |
3620 JOSEPH SIEWICK DR STE 201 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-1758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053883579 | Da Yon Park | Physician Assistant | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2018-12-21 |
| 1720569486 | Jeffrey Tsai | Physical Therapist | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2018-08-22 |
| 1396270310 | Jessica Nicole Ortega | Physician Assistant | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2017-04-27 |
| 1265892608 | Lauren Cully | Physician Assistant | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2016-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831751148 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 125 Akers Farm Rd Ste C&d, Christiansburg, VA 24073-4866 | 2019-07-08 |
| 1881171718 | Franklin Clinic Corp | Orthopaedic Surgery | 210 Fairview Dr Ste A, Franklin, VA 23851-1216 | 2018-07-24 |
| 1932638921 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 1787 W. Lee Hwy, Forest Medical Park, Unit B, Bldg 2, Wytheville, VA 24382-1437 | 2017-06-05 |
| 1477956878 | Virginia Commonwealth University | Orthopaedic Surgery | 821 W Franklin St, Richmond, VA 23284-9012 | 2014-09-30 |
| 1871920132 | Mark T Wolfe | Orthopaedic Surgery | 3906 Breezeport Way, Apt 105, Suffolk, VA 23435-1080 | 2013-10-02 |
| 1750724167 | Ryan Austin Harrell | Orthopaedic Surgery | 5818 Harbour View Blvd Ste 150d, Suffolk, VA 23435-3327 | 2013-04-16 |
| 1306088687 | Nathan William Coleman | Orthopaedic Surgery | 13350 Franklin Farm Rd Ste 220, Herndon, VA 20171-4095 | 2009-04-01 |
| 1467662791 | Stephen F. Brockmeier | Orthopaedic Surgery | 515 Ray C Hunt Dr Ste 1100, Charlottesville, VA 22903-2981 | 2007-05-23 |
| 1386706620 | David R. Diduch | Orthopaedic Surgery | 515 Ray C. Hunt Dr, Charlottesville, VA 22903-2981 | 2006-12-14 |
| 1821065848 | Mark D. Miller | Orthopaedic Surgery | 400 Ray C Hunt Dr, Suite 330, Charlottesville, VA 22903-2980 | 2006-03-08 |
| 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.