Organization Active NPI

Van Roo Family Chiropractic LLC

  • Chiropractor
  • Janesville, WI
National Provider Identifier
1033511688
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VAN ROO FAMILY CHIROPRACTIC LLC
Practice address
2505 Milton Ave
Janesville, WI 53545-0441
Phone
(608) 756-5225
Fax
(608) 756-0506
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Ryan T Van Roo, DCNPI 1003916610
Title
President
Phone
(608) 756-5225

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2505 Milton Ave
Janesville, WI 53545-0441

Mailing address

2505 Milton Ave
Janesville, WI 53545-0441
Phone (608) 756-5225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150102001031 WI Part B Supplier - Clinic/Group Practice 9638492366 Receives reassigned benefits from 3 practitioners
Practice locations: Janesville, WI

National Provider Directory

National Provider Directory

Locations

1711 Holiday Dr
Ste 100
Janesville, WI 53545
Phone (608) 756-5225

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1033511688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MILTON AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450441",
            "telephone_number": "608-756-5225",
            "fax_number": "608-756-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MILTON AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450441",
            "telephone_number": "608-756-5225",
            "fax_number": "608-756-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN ROO FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "VAN ROO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-756-5225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.