Organization Active NPI

South Main Pain, Inc.

  • Chiropractor
  • Belle Glade, FL
National Provider Identifier
1073735577
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOUTH MAIN PAIN, INC.
Practice address
607 South Main Street
Suite 102
Belle Glade, FL 33430
Phone
(561) 996-1900
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard J Ridky, DCNPI 1306064951
Title
President
Phone
(561) 432-6021

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

607 South Main Street
Suite 102
Belle Glade, FL 33430

Mailing address

7024 Charleston Shores Blvd
Lake Worth, FL 33467
Phone (561) 432-6021

National Provider Directory

National Provider Directory

Locations

607 S Main St
Ste 102
Belle Glade, FL 33430
Phone (561) 996-1900

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073735577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7024 CHARLESTON SHORES BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33467",
            "telephone_number": "561-432-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 SOUTH MAIN STREET",
            "address_2": "SUITE 102",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "33430",
            "telephone_number": "561-996-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MAIN PAIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIDKY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-432-6021",
        "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 Belle Glade, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.