Individual provider Active NPI

Paul Ryan Anderson, D.C.

  • Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1255368221
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06596 Issued in IA
Practice address
1849 51St St NE
Cedar Rapids, IA 52402-2458
Phone
(319) 743-0020
Fax
(319) 743-0040
NPI assigned
Jun 27, 2006
Last updated
Aug 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06596 IA Primary

Addresses

Primary practice location

1849 51St St NE
Cedar Rapids, IA 52402-2458

Mailing address

1921 51St St NE
Ste 6
Cedar Rapids, IA 52402-2400
Phone (319) 743-0020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000195 IA Practitioner - Chiropractic 1850387929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1921 51St St NE
Suite 6
Cedar Rapids, IA 52402-2400
Phone (319) 743-0020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06596IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Rapids Chiropractic LLC Chiropractor CurrentSince May 15, 2006 Accepting new patients

Locations

1849 51st St NE
Cedar Rapids, IA 52402
Phone (319) 743-0020

1921 51st St NE
Ste 6
Cedar Rapids, IA 52402
Phone (319) 743-0020

Organizations & group practices 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1255368221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 51ST ST NE",
            "address_2": "STE 6",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022400",
            "telephone_number": "319-743-0020",
            "fax_number": "319-743-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 51ST ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022458",
            "telephone_number": "319-743-0020",
            "fax_number": "319-743-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PAUL",
        "middle_name": "RYAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.