Individual provider Active NPI

Ryan Phillip Laqua, D.C.

  • Chiropractor
  • Sidney, MT
National Provider Identifier
1093877995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
986 Issued in MT
Practice address
222 2ND Ave SW
Sidney, MT 59270-4020
Phone
(406) 433-4757
Fax
(406) 433-1131
NPI assigned
Dec 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 986 MT Primary

Addresses

Primary practice location

222 2ND Ave SW
Sidney, MT 59270-4020

Mailing address

222 2ND Ave SW
Sidney, MT 59270-4020
Phone (406) 433-4757

Other identifiers 1

IdentifierTypeStateIssuer
40363OtherMTBCBS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120405000671 MT Practitioner - Chiropractic 7416117338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 2ND Ave SW
Sidney, MT 59270-4020
Phone (406) 433-4757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
986MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
R Laqua PC Chiropractor CurrentSince Mar 29, 2012 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

222 2nd Ave SW
Sidney, MT 59270
Phone (406) 433-4757

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093877995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 2ND AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592704020",
            "telephone_number": "406-433-4757",
            "fax_number": "406-433-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 2ND AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592704020",
            "telephone_number": "406-433-4757",
            "fax_number": "406-433-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAQUA",
        "first_name": "RYAN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  PROVIDER NUMBER",
            "identifier": "40363",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.