DR. RYAN R CICENAS MD
Complete NPI Record 1679539522
Internal Medicine in Scott Depot, WV
Active since April 20, 2006PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Dr. Ryan R Cicenas, MD (NPI 1679539522), an individual internal medicine provider in Scott Depot, WV. All 51 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1679539522 Field 1/51
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/51
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: CICENAS Field 3/51
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: RYAN Field 4/51
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: R Field 5/51
- The middle name of the provider, if the provider is an individual.
- Provider Name Prefix Text: DR. Field 6/51
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: MD Field 7/51
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: PO BOX 1680 Field 8/51
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: HUNTINGTON Field 9/51
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: WV Field 10/51
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 257171680 Field 11/51
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/51
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3047815159 Field 13/51
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 3045238115 Field 14/51
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 111 GREAT TEAYS BLVD STE 101 Field 15/51
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: SCOTT DEPOT Field 16/51
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: WV Field 17/51
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 255609548 Field 18/51
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 19/51
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3047578803 Field 20/51
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 3047576904 Field 21/51
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 24/51
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 207R00000X Field 25/51
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 35.134827 Field 26/51
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: OH Field 27/51
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 28/51
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 208000000X Field 29/51
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 21594 Field 30/51
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: WV Field 31/51
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 32/51
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 208000000X Field 33/51
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: 35.134827 Field 34/51
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: OH Field 35/51
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 36/51
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 207R00000X Field 37/51
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 4: 21594 Field 38/51
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 4: WV Field 39/51
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 4: Y Field 40/51
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 0318066 Field 41/51
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 42/51
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: OH Field 43/51
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 2: 010097096 Field 44/51
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 05 Field 45/51
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: VA Field 46/51
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 3: 1679539522 Field 47/51
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 3: 05 Field 48/51
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 3: WV Field 49/51
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 50/51
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 22
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
3729 Teays Valley Rd Ste 100
Location 1/22Hurricane, WV 25526-9705 · Phone (304) 760-6040 · Fax (304) 760-6042
1347 Hillview Dr
Location 2/22Milton, WV 25541-1513 · Phone (304) 743-1407 · Fax (304) 743-4516
864 Oakwood Rd
Location 3/22Charleston, WV 25314-2010 · Phone (304) 352-1191 · Fax (681) 265-5161
2585 3rd Ave
Location 4/22Huntington, WV 25703-1642 · Phone (304) 697-1396 · Fax (304) 697-2086
723 9th Ave
Location 5/22Huntington, WV 25701-2718 · Phone (304) 529-0645 · Fax (304) 529-3026
930 2nd St
Location 6/22Huntington, WV 25701-3146 · Phone (304) 528-2070 · Fax (304) 529-3026
1 Timberwolf Ln
Location 7/22Huntington, WV 25704-9377 · Phone (304) 429-1764 · Fax (304) 429-1746
100 Pioneer Rd
Location 8/22Wayne, WV 25570-9504 · Phone (304) 272-3783 · Fax (304) 272-3807
42 McGinnis Dr
Location 9/22Wayne, WV 25570-9553 · Phone (304) 272-5136 · Fax (304) 272-6261
2908 Auburn Rd
Location 10/22Huntington, WV 25704-2715 · Phone (304) 781-5800 · Fax (304) 781-5504
71 Wayne St
Location 11/22Fort Gay, WV 25514-8518 · Phone (304) 648-5544 · Fax (304) 648-5989
1301 Hal Greer Blvd
Location 12/22Huntington, WV 25701-3803 · Phone (304) 525-0572 · Fax (304) 529-1119
2501 Jackson Ave
Location 13/22Point Pleasant, WV 25550-2035 · Phone (304) 857-0004 · Fax (304) 857-0005
85 Donohoe Dr
Location 14/22Huntington, WV 25705-8887 · Phone (304) 399-3310
1246 McClellan Hwy
Location 15/22Harts, WV 25524-9524 · Phone (304) 310-1246 · Fax (304) 310-1248
6350 US Route 60 E
Location 16/22Barboursville, WV 25504-1232 · Phone (304) 399-3350 · Fax (304) 955-5047
2300 US Route 60
Location 17/22Ona, WV 25545-9712 · Phone (304) 743-7495 · Fax (304) 743-6660
1100 Hospital Dr
Location 18/22Hurricane, WV 25526-8712 · Phone (304) 757-8803 · Fax (304) 757-8684
106 Huffard Dr
Location 19/22Bluefield, VA 24605-9209 · Phone (276) 322-3427 · Fax (276) 322-4640
408 Alexander St
Location 20/22Cedar Grove, WV 25309 · Phone (304) 595-1770 · Fax (304) 595-3298
205 Marion Pike
Location 21/22Coal Grove, OH 45638-3165 · Phone (740) 532-1188 · Fax (740) 532-1183
111 Great Teays Blvd Ste 101
Location 22/22Scott Depot, WV 25560-9548 · Phone (304) 757-8803 · Fax (304) 757-6904
Other Provider Identifiers 3
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
0318066 Medicaid
Identifier 1/3State: OH
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
010097096 Medicaid
Identifier 2/3State: VA
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
1679539522 Medicaid
Identifier 3/3State: WV
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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