Individual provider Active NPI

Ross Michael William Reynolds, D.C.

  • Chiropractor
  • Rock Rapids, IA
National Provider Identifier
1063768679
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007559 Issued in IA
Practice address
206 S Union St
Rock Rapids, IA 51246-1338
Phone
(712) 472-2481
Fax
(712) 472-2481
NPI assigned
Aug 1, 2012
Last updated
Aug 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007559 IA Primary
Chiropractor 111N00000X 5696 MN

Addresses

Primary practice location

206 S Union St
Rock Rapids, IA 51246-1338

Mailing address

206 S Union St
Rock Rapids, IA 51246-1338
Phone (712) 472-2481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131031001540 IA Practitioner - Chiropractic 6002066693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

206 S Union St
Rock Rapids, IA 51246-1338
Phone (712) 472-2481

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007559IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rapids Chiropractic PC Chiropractor CurrentSince Dec 26, 2013 Accepting new patients
Southwest Chiropractic. LLC Chiropractor PastSince Apr 21, 2024 Accepting new patients

Locations

206 S Union St
Rock Rapids, IA 51246
Phone (712) 472-2481

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1063768679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S UNION ST",
            "city": "ROCK RAPIDS",
            "state": "IA",
            "postal_code": "512461338",
            "telephone_number": "712-472-2481",
            "fax_number": "712-472-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S UNION ST",
            "city": "ROCK RAPIDS",
            "state": "IA",
            "postal_code": "512461338",
            "telephone_number": "712-472-2481",
            "fax_number": "712-472-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROSS",
        "middle_name": "MICHAEL WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007559",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.