Ryder Michael Church, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038007166 Issued in IL

Practice address

901 W Glen Ave
Suite a
Peoria, IL 61614-4836

Phone

(309) 693-1212

Fax

(309) 693-2147

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Cotton Chiropractic, LLC

  • Chiropractor
  • Peoria, IL
  • NPI 1013318336
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1104898659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W GLEN AVE",
            "address_2": "SUITE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144836",
            "telephone_number": "309-693-1212",
            "fax_number": "309-693-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W GLEN AVE",
            "address_2": "SUITE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144836",
            "telephone_number": "309-693-1212",
            "fax_number": "309-693-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "RYDER",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038007166",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noah Christopher
• Herminia Josefina Christy, LCSW
• Guoxiang Chu, MD
• Jamie M Chu, PHARM.D.
• Snigda Chukka, M.D.
• Anna Cicciarelli, APN
• Kara Sue Cicciarelli, PHD, NCSP, LCP
• Scott Joseph Cicciarelli Jr.
• Sarah Cimei, PHARMD
• Brynn N Cinnamon, APN/CNP

• Chiropractor in Peoria, IL
• Providers in Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.