Individual provider Active NPI

Daryl Lee Ridgeway, DC

  • Chiropractor
  • Wentzville, MO
National Provider Identifier
1043371610
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006613 Issued in MO
Practice address
1023 Main Plaza Dr
Wentzville, MO 63385-1170
Phone
(636) 639-8944
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006613 MO Primary

Addresses

Primary practice location

1023 Main Plaza Dr
Wentzville, MO 63385-1170

Mailing address

1023 Main Plaza Dr
Wentzville, MO 63385-1170
Phone (636) 639-8944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051117000004 MO Practitioner - Chiropractic 7214956572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1023 Main Plaza Dr
Wentzville, MO 63385-1170
Phone (636) 639-8944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • IA HMO
  • IA HMO C-SNP

Organizations & group practices 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1043371610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 MAIN PLAZA DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851170",
            "telephone_number": "636-639-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 MAIN PLAZA DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851170",
            "telephone_number": "636-639-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGEWAY",
        "first_name": "DARYL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.