Organization Active NPI

Joe W Ryan LLC

  • Chiropractor
  • Mount Horeb, WI
National Provider Identifier
1053657429
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4277-012 Issued in WI
Legal business name
JOE W RYAN LLC
Practice address
1840 Business 18 and 151 E
Mount Horeb, WI 53572-2471
Phone
(608) 437-0099
Fax
(608) 437-1999
NPI assigned
Dec 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Dr. Joseph William Ryan, D.C.NPI 1588714349
Title
Doctor/Owner
Phone
(608) 437-0099

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 4277-012 WI Primary

Addresses

Primary practice location

1840 Business 18 and 151 E
Mount Horeb, WI 53572-2471

Mailing address

1840 Business 18 and 151 E
Mount Horeb, WI 53572-2471
Phone (608) 437-0099

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130110000467 WI Part B Supplier - Clinic/Group Practice 6709039332 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Horeb, WI

National Provider Directory

National Provider Directory

Locations

1840 Springdale St
Mount Horeb, WI 53572
Phone (608) 437-0099

Practitioners & affiliated clinicians

Practitioners 1

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": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1053657429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 BUSINESS 18 AND 151 E",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535722471",
            "telephone_number": "608-437-0099",
            "fax_number": "608-437-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 BUSINESS 18 AND 151 E",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535722471",
            "telephone_number": "608-437-0099",
            "fax_number": "608-437-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE W RYAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "608-437-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4277-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Horeb, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.