Provider Demographics
NPI:1891805933
Name:FERRELL, RYAN STUART (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:STUART
Last Name:FERRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501NW 62ND TERRACE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2408
Mailing Address - Country:US
Mailing Address - Phone:816-584-8884
Mailing Address - Fax:913-945-9612
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:G600
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:913-588-9770
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30349207RC0000X
MO2006012202207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO38331017OtherBCBS KC
KS106470OtherBCBS KS
KS200435540AMedicaid
MO207340506Medicaid
KS200435540BMedicaid
KS200435540BMedicaid
KS106470Medicare PIN
MOP00643130Medicare PIN
KS038F211BMedicare PIN
MO38331017OtherBCBS KC
MO038F211EMedicare PIN