RYAN BONNER – Orthopedic Physical Therapist, NPI 1275421919

RYAN BONNER is a healthcare provider. based in Glen allen, Virginia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 2305217164 (VA). The NPI Number for RYAN BONNER is 1275421919

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
RYAN BONNER
NPI
1275421919
Phone
(804) 270-7754
Address
5300 HICKORY PARK DR STE 110
Enumeration Date
24 June 2025
Last Update Date
24 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8042707754
Graduation Year
2025 (1 year ago)
PAC ID
5092214619
Group Practice PAC ID
3779588256
Professional Enrollment ID
I20250819004078
Address ID
VA230592629GL5300XDRXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

3,080 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VA

Provider Addresses for RYAN BONNER

  • 5300 HICKORY PARK DR STE 110

    GLEN ALLEN, VA 230592629

    Phone: (804) 270-7754

    Fax: (804) 270-7754

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20250819004078IPhysical Therapist In Private PracticeVATBD

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 23059)

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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: 3779588256View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
-VA
Physical Therapist In Private PracticeVA
-MD
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
-VA

Reviews

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Frequently asked questions

Is RYAN BONNER listed with a National Provider Identifier?
Yes — RYAN BONNER has NPI 1275421919 on file in the registry.
Would RYAN BONNER appear as active to a payer?
You can treat RYAN BONNER as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with RYAN BONNER?
RYAN BONNER's record emphasizes Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
Is RYAN BONNER associated with Glen Allen?
Public fields place RYAN BONNER around Glen Allen, Virginia. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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