RYAN J THORDAL D.O.
NPI 1871848846
General Practice in Mcconnell Afb, KS

Q: What is Ryan Thordal's NPI number?

The NPI number for Ryan Thordal is 1871848846. It was assigned to this individual provider in the NPPES registry on July 17, 2012.

Q: What is Ryan Thordal's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Ryan Thordal was last updated on April 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since July 17, 2012PECOS Enrolled

57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221(316) 759-5116 Get Directions Write a Review

NPPES record last updated: April 12, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ryan J Thordal D.o. NPPES

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

RYAN J THORDAL D.O. (NPI 1871848846) is an individual general practice provider in Mcconnell Afb, Kansas, licensed in Minnesota (57333) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with St Mary's Healthcare, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1871848846

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameRYAN J THORDALCredential: D.O.

Location Address57950 LEAVENWORTH STMcconnell Afb, KS 67221-3506

Mailing Address324 N Emporia Ave Apt 321Wichita, KS 67202-2548 · (218) 415-1462

Phone(316) 759-5116

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateJuly 17, 2012

Last NPPES UpdateApril 12, 2018

✔ NPI 1871848846 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in MN · 57333

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedInternal MedicineTaxonomy 207R00000X · License 253114 (MA)

57950 LEAVENWORTH ST, Mcconnell Afb, KS 67221

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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)

Ryan J Thordal D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799119236

PECOS Enrollment IDI20250728001638

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary's Healthcare

Acute Care Hospitals · Amsterdam, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330047

Location427 Guy Park AvenueAmsterdam, NY 12010 · Montgomery County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER LYNN VARNEY DNP, FNP-BC

Nurse Practitioner (Family)