Daryl Ridgeway DC LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

006613 Issued in MO

Legal business name

DARYL RIDGEWAY DC LLC

Practice address

1023 Main Plaza Dr
Wentzville, MO 63385-1170

Phone

(636) 639-8944

NPI assigned

Sep 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daryl Lee Ridgeway, DCNPI 1043371610

Title

Chiropractor

Phone

(636) 639-8944

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

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

• Daryl Lee Ridgeway, DC

  • Chiropractor
  • Wentzville, MO
  • NPI 1043371610
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1053506097",
    "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": {
        "organization_name": "DARYL RIDGEWAY DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "RIDGEWAY",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "636-639-8944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Dalton
• Damien Sampson LLC
• Lacretia M Daniels, NP
• Jacqueline Marie Dann, LMSW
• Amanda Darby, FNP
• David E Peaco,PHD,LLC
• Janisha Davis
• Karen Ann Davis
• Melanie R Davis, LPC
• Xephyr Day, D.C.

• Chiropractor in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.