Individual provider Active NPI

Richard Joseph Ridky, DC

  • Chiropractor
  • Lake Worth, FL
National Provider Identifier
1306064951
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7581 Issued in FL
Practice address
7026 Charleston Shores Blvd
Lake Worth, FL 33467-7628
Phone
(561) 432-6021
Fax
(561) 432-6022
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7581 FL Primary

Addresses

Primary practice location

7026 Charleston Shores Blvd
Lake Worth, FL 33467-7628

Mailing address

7026 Charleston Shores Blvd
Lake Worth, FL 33467-7628
Phone (561) 432-6021

Other identifiers 1

IdentifierTypeStateIssuer
55769OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Main Pain, Inc. Chiropractor PastSince Jul 19, 2010 Accepting new patients
Key Medical Associates, LLC Chiropractor Past Accepting new patients
Polo Medical Center Inc Chiropractor Past Accepting new patients

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1306064951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 CHARLESTON SHORES BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677628",
            "telephone_number": "561-432-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7026 CHARLESTON SHORES BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677628",
            "telephone_number": "561-432-6021",
            "fax_number": "561-432-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDKY",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "55769",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.