Individual provider Active NPI

Saul Eldon Ribellia, D.C.

  • Chiropractor
  • Moses Lake, WA
National Provider Identifier
1003975103
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034472 Issued in WA
Practice address
821 E Broadway Ave
Suite 18
Moses Lake, WA 98837-5934
Phone
(509) 766-7300
Fax
(509) 766-7400
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034472 WA Primary

Addresses

Primary practice location

821 E Broadway Ave
Suite 18
Moses Lake, WA 98837-5934

Mailing address

821 E Broadway Ave
Suite 18
Moses Lake, WA 98837-5934
Phone (509) 766-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051123000481 WA Practitioner - ChiropracticPractitioner - Oral Surgery 2769401595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Ribellia Chiropractic Enterprises PLLCGroup PAC ID 1052730488, 2 clinicians

Practice addresses (Care Compare)

305 E Broadway Ave
Moses Lake, WA 98837-1719
Phone (509) 766-8428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034472WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ribellia Chiropractic Enterprises PLLC Chiropractor CurrentSince Jun 5, 2020 Accepting new patients
Life Wellness Chiropractic LLC Chiropractor PastSince Aug 1, 2005 Accepting new patients

Locations

305 E Broadway Ave
Moses Lake, WA 98837
Phone (509) 766-7300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003975103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E BROADWAY AVE",
            "address_2": "SUITE 18",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988375934",
            "telephone_number": "509-766-7300",
            "fax_number": "509-766-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E BROADWAY AVE",
            "address_2": "SUITE 18",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988375934",
            "telephone_number": "509-766-7300",
            "fax_number": "509-766-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBELLIA",
        "first_name": "SAUL",
        "middle_name": "ELDON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.