Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Alexandra Gray Ryan

Individual provider Physician Assistant · NPI 1083479620

Miss. Alexandra Gray Ryan is a Physician Assistant in Hollywood, South Carolina. Qualified in 2025, 1 year ago. Registered with an NPI since 2024.

Years since qualifying
1
In the registry since
2024
Specialties on file
2

Practice location Address checks out

4710 Hard Scuffle Ln
Hollywood, SC 29449-5781
Phone: (854) 500-6432
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1083479620
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 13, 2024
Last updated in NPPESFebruary 13, 2024
Certification dateFebruary 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare