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MISS ALEXANDRA GRAY RYAN
NPI 1083479620
Student in an Organized Health Care Education/Training Program in Hollywood, SC

Active since February 13, 2024PECOS Enrolled
4710 HARD SCUFFLE LN, HOLLYWOOD, SC 29449(854) 500-6432 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Miss Alexandra Gray Ryan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS ALEXANDRA GRAY RYAN (NPI 1083479620) is an individual student in an organized health care education/training program in Hollywood, South Carolina and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083479620
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMISS ALEXANDRA GRAY RYAN
Location Address4710 HARD SCUFFLE LNHollywood, SC 29449-5781
Mailing Address4710 Hard Scuffle LnHollywood, SC 29449-5781 · (854) 500-6432
Phone(854) 500-6432
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 13, 2024
NPPES CertifiedFebruary 13, 2024
✔ NPI 1083479620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPhysician AssistantTaxonomy 363A00000X
4710 HARD SCUFFLE LN, Hollywood, SC 29449
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Alexandra Gray Ryan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204317746
PECOS Enrollment IDI20260224000644
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alexandra Ryan's NPI number?

The NPI number for Alexandra Ryan is 1083479620. It was assigned to this individual provider in the NPPES registry on February 13, 2024.

Where is Alexandra Ryan located?

Alexandra Ryan practices at 4710 Hard Scuffle Ln, Hollywood, SC 29449. The listed phone number is (854) 500-6432.

What is Alexandra Ryan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Alexandra Ryan enrolled in Medicare?

Yes. Alexandra Ryan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alexandra Ryan was last updated on February 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.