KELLY RYAN (PMHNP-BC, APRN-CNP) – Family Nurse Practitioner, NPI 1134675192

KELLY RYAN (PMHNP-BC, APRN-CNP) is a healthcare provider. based in Traverse city, Michigan. specializing in Family Nurse Practitioner. They hold the professional credentials PMHNP-BC, APRN-CNP. They hold a License No. PMHNP-BC (MI). The NPI Number for KELLY RYAN (PMHNP-BC, APRN-CNP) is 1134675192

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
KELLY RYAN (PMHNP-BC, APRN-CNP)
NPI
1134675192
Phone
(231) 935-0799
Address
1719 S GARFIELD AVE
Enumeration Date
30 August 2016
Last Update Date
23 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9372725926
Graduation Year
2013 (13 years ago)
PAC ID
6608156716
Group Practice PAC ID
6800078791
Professional Enrollment ID
I20161207001519
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Digital endpointsOther names

Provider Addresses for KELLY RYAN (PMHNP-BC, APRN-CNP)

  • 1719 S GARFIELD AVE

    TRAVERSE CITY, MI 496864337

    Phone: (231) 935-0799

    Fax: (231) 935-0962

    Type: Location

  • Shepherd Farm, West Chester Township, Butler County, Ohio, 45069, United States

    WEST CHESTER, OH 450691128

    Phone: (513) 942-9500

    Type: Mailing

  • 3155 LOGAN VALLEY RD

    TRAVERSE CITY, MI 496844772

    Phone: (402) 677-9083

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $173.

Total Amount is formed as General ($173) + Research ($0) + Ownership ($0) = $173.

Last reported payment date: 2024-09-17 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($100).

Total Amount

$173

General + Research + Ownership

Payments

4

Total payment records

General Amount

$173

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161207001519INurse PractitionerOHTBD
I20200715002313INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49686)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800078791View full group profile
NameSpecialtyState
-OH
Clinical Social WorkerOH
Mental Health CounselorOH
-OH
Clinical Social WorkerOH
Psychiatry, Geriatric PsychiatryOH

Reviews

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Frequently asked questions

What is the registry number for KELLY RYAN (PMHNP-BC, APRN-CNP)?
The registry entry for KELLY RYAN (PMHNP-BC, APRN-CNP) shows NPI 1134675192.
Quick check: is KELLY RYAN (PMHNP-BC, APRN-CNP) active?
Public NPPES data shows KELLY RYAN (PMHNP-BC, APRN-CNP) with an active NPI status right now.
How should patients interpret KELLY RYAN (PMHNP-BC, APRN-CNP)'s specialty?
The extract shows Family Nurse Practitioner for KELLY RYAN (PMHNP-BC, APRN-CNP). Clinical services aligned with this taxonomy classification.
What geographic area is tied to KELLY RYAN (PMHNP-BC, APRN-CNP)?
KELLY RYAN (PMHNP-BC, APRN-CNP) is associated with Traverse City, Michigan in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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