Ruddell Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-503 Issued in ID

Legal business name

RUDDELL CHIROPRACTIC CLINIC

Practice address

1117 16TH Ave
Lewiston, ID 83501-3739

Phone

(208) 743-8401

Fax

(208) 743-8722

NPI assigned

Jun 27, 2007

Last updated

Mar 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian T Ruddell, D.C.NPI 1770648388

Title

Chiropractor

Phone

(208) 743-8401

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian T Ruddell, DC

  • Chiropractor
  • Lewiston, ID
  • NPI 1770648388
  Medicare reassignment Care Compare group NPD Authorized official
• Kevin Patrick Ruddell, DC

  • Chiropractor
  • Lewiston, ID
  • NPI 1013072669
  Medicare reassignment Care Compare group NPD
• Linda Louise McGrale, LICENSED MASSAGE PRA

  • Massage Therapist
  • Lewiston, ID
  • NPI 1093839110
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1225235906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 16TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013739",
            "telephone_number": "208-743-8401",
            "fax_number": "208-743-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 16TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013739",
            "telephone_number": "208-743-8401",
            "fax_number": "208-743-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDDELL CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "RUDDELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "208-743-8401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805054900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon R. Rowland, PMHNP
• Margeret Roy
• Monali Roy
• Royal Plaza Retirement Center Lewiston, LLC
• Tyra Darrean Ruberti
• Brian T Ruddell, DC
• Kevin Patrick Ruddell, DC
• John Bradley Rudolph, D.O.
• Stephanie Lynn Ruggiero-Bodden, LMSW
• Pedro E Ruiz, D.M.D.

• Chiropractor in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.