Organization Active NPI

Ryan Family Chiropractic, Inc.

  • Chiropractor
  • Statesboro, GA
National Provider Identifier
1013196096
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RYAN FAMILY CHIROPRACTIC, INC.
Practice address
303 Donehoo St
Statesboro, GA 30458
Phone
(912) 489-5559
Fax
(912) 489-3028
NPI assigned
Oct 26, 2007
Last updated
Jun 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Authorized official

Name
Jason R Ryan, D.C.NPI 1275605123
Title
Owner
Phone
(912) 489-5553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X GA Primary

Addresses

Primary practice location

303 Donehoo St
Statesboro, GA 30458

Mailing address

303 Donehoo St
Statesboro, GA 30458
Phone (912) 489-5559

Other identifiers 1

IdentifierTypeStateIssuer
GRP4994MedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040630000289 GA Part B Supplier - Clinic/Group Practice 4789661562 Practice locations: Statesboro, GA

National Provider Directory

National Provider Directory

Locations

303 Donehoo St
Statesboro, GA 30458
Phone (912) 489-5559

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1013196096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 DONEHOO ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-5559",
            "fax_number": "912-489-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 DONEHOO ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-5559",
            "fax_number": "912-489-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-489-5553",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GRP4994",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.