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Ryian Crenshaw

Physician β€’ Ponca City, OK

Active NPI 1639565153 Individual Practitioner Female Practitioner
Practice location in NPPES

410 Fairview Ave
Ponca City, OK 746011922

Call 5807494227 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

410 Fairview Ave

Ponca City, OK 746011922

Telephone 5807494227
Organization at the Same NPPES Address or Phone
Klr Innovations Llc Facility NPI 1952876492

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2015

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-01-04
Point of Service Primary Specialty

NUCC Taxonomy Code: 305S00000X

License # reported to NPPES OK 1069

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oklahoma State Board of Medical Licensure.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location March 30, 2021

Registered at 410 FAIRVIEW AVE, PONCA CITY, OK 746011922 (Tel: 5807494227)

πŸ“
Updated Business Mailing Address March 30, 2021

Registered at 410 FAIRVIEW AVE, PONCA CITY, OK 746011922 (Tel: 5807494227)

πŸ‘€
Provider Name / Credentials Updated March 30, 2021

Recorded as RYIAN CRENSHAW

βœ…
NPI Profile Active April 10, 2015

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 10, 2015

Registered at 2101 N 14TH, SUITE 134, PONCA CITY, OK 74601 (Tel: 5807494227)

πŸ“
Business Mailing Address (Initial Record) April 10, 2015

Registered at 2103 N 14TH, SUITE 134, PONCA CITY, OK 74601 (Tel: 5807494227)

πŸ‘€
Provider Name / Credentials (Initial Record) April 10, 2015

Recorded as RYIAN REYES

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 10, 2015

Point of Service (license number reported to NPPES: OK 1069)

🟒
Initial NPI Registration & Enumeration April 10, 2015

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1639565153
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 10, 2015
Last Update: March 30, 2021
Sole Proprietor: Yes

Mailing Address

410 Fairview Ave

Ponca City, OK 746011922

Phone: 5807494227

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.