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

Ryan Averill

Individual provider Sports Medicine (Emergency Medicine) Physician · NPI 1376286021

Ryan Averill is an Emergency Medicine in Jackson, Mississippi. Qualified in 2021, 5 years ago. Practices with Modern Physician Services PC, a 53-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
5
Licensed in
MS
In the registry since
2022

Practice location Address checks out

1410 E Woodrow Wilson Ave
Jackson, MS 39216-5114
Phone: (601) 984-5525
Show map & directions

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

Specialties & licences

Sports Medicine (Emergency Medicine) Physician (primary) Taxonomy 207PS0010X · Licence 36950 (MS)

Record details

NPI number1376286021
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 19, 2022
Last updated in NPPESJune 23, 2026
Certification dateJune 23, 2026
Mailing address1410 E Woodrow Wilson Ave, Jackson, MS 39216-5114

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Modern Physician Services Pc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare