Individual provider Active NPI

Ryan Smart, DC

  • Chiropractor
  • Silverdale, WA
National Provider Identifier
1164539896
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034623 Issued in WA
Practice address
9119 Ridgetop Blvd NW Ste 160
Silverdale, WA 98383-8549
Phone
(360) 215-7246
Fax
(360) 215-7282
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034623 WA Primary

Addresses

Primary practice location

9119 Ridgetop Blvd NW Ste 160
Silverdale, WA 98383-8549

Mailing address

1016 NE Forest Rock LN Ste 105
Poulsbo, WA 98370-9040
Phone (360) 779-5580

Other identifiers 1

IdentifierTypeStateIssuer
1164539896MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070207000425 WA Practitioner - Chiropractic 5395747182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9119 Ridgetop Blvd NW
Suite 160
Silverdale, WA 98383-8549
Phone (360) 215-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Chiropractic PLLC Chiropractor CurrentSince Mar 1, 2011 Accepting new patients
Life Force Chiropractic of Poulsbo Inc Chiropractor PastSince Jul 24, 2022 Accepting new patients
Smart Energy Healing LLC Chiropractor Past Accepting new patients

Locations

1016 NE Forest Rock Ln
Ste 105
Poulsbo, WA 98370
Phone (360) 779-5580

9119 Ridgetop Blvd NW
Ste 160
Silverdale, WA 98383
Phone (360) 215-7246

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1164539896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 NE FOREST ROCK LN STE 105",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709040",
            "telephone_number": "360-779-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 RIDGETOP BLVD NW STE 160",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838549",
            "telephone_number": "360-215-7246",
            "fax_number": "360-215-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164539896",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.