Dylln Thane Rider, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0007783 Issued in CO

Practice address

39 S Parish Ave Unit 120
Johnstown, CO 80534-7855

Phone

(307) 359-2142

Fax

(970) 703-8151

NPI assigned

Mar 14, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hatch Chiropractic

  • Chiropractor
  • Parker, CO
  • NPI 1316261241
  NPD (past)

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1306349527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 ALDER AVE",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805349133",
            "telephone_number": "970-578-0082",
            "fax_number": "970-703-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 S PARISH AVE UNIT 120",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805347855",
            "telephone_number": "307-359-2142",
            "fax_number": "970-703-8151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10841 Crossroads Dr Ste 17",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801349090",
            "country_code": "US",
            "telephone_number": "303-841-7121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDER",
        "first_name": "DYLLN",
        "middle_name": "THANE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CO",
            "license": "0007783",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "0007783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1306349527",
            "identifier": "853782542",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Johnstown, CO
• Providers in Johnstown, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.