Individual provider Active NPI

Ryan Brinker, DC

  • Chiropractor
  • O Fallon, MO
National Provider Identifier
1235536657
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2014041507 Issued in MO
Practice address
2520 Highway K
O Fallon, MO 63368-6625
Phone
(636) 978-5511
Fax
(636) 281-5511
NPI assigned
Dec 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2014041507 MO Primary

Addresses

Primary practice location

2520 Highway K
O Fallon, MO 63368-6625

Mailing address

2520 Highway K
O Fallon, MO 63368-6625
Phone (636) 978-5511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141218000260 MO Practitioner - Chiropractic 3870816127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back Pain Center LLCGroup PAC ID 5698874154, 6 clinicians

Practice addresses (Care Compare)

2530 Hwy K
O Fallon, MO 63368-6625
Phone 63697855113

905 Main Plaza Dr
Wentzville, MO 63385-1168
Phone (636) 856-1260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014041507MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back Pain Center LLC Chiropractor CurrentSince Dec 3, 2014 Accepting new patients
Cowser Spine and Sport Chiropractor PastSince Jun 23, 2025 Accepting new patients

Locations

2520 Highway K
O Fallon, MO 63368
Phone (636) 978-5511

2530 Highway K
O Fallon, MO 63368
Phone (636) 978-5511

905 Main Plaza Dr
Wentzville, MO 63385
Phone (636) 856-1260

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1235536657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686625",
            "telephone_number": "636-978-5511",
            "fax_number": "636-281-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686625",
            "telephone_number": "636-978-5511",
            "fax_number": "636-281-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-01",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2014041507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.