Individual provider Active NPI

Ryan W. Nolte, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1316336803
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6012 Issued in MN
Practice address
1150 Montreal Ave Ste 101
Saint Paul, MN 55116
Phone
(651) 293-1497
Fax
(763) 717-2988
NPI assigned
Jan 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 6012 MN Primary

Addresses

Primary practice location

1150 Montreal Ave Ste 101
Saint Paul, MN 55116

Mailing address

1150 Montreal Ave Ste 101
Saint Paul, MN 55116-2393
Phone (651) 293-1497

Other practice location 1

199 Coon Rapids Blvd NW
Suite 315
Coon Rapids, MN 55433-5831
Phone (763) 717-9510

Other practice location 2

199 Coon Rapids Blvd NW
Suite 315
Coon Rapids, MN 55433-5831
Phone (763) 717-9510

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

State licenses

LicenseStateTypeSpecialty
6012MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
William C. Gustafson, D.C., P.a. Chiropractor CurrentSince Jun 28, 2015 Accepting new patients

Locations

199 Coon Rapids Blvd NW
Ste 315
Minneapolis, MN 55433
Phone (763) 717-9510

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1316336803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 MONTREAL AVE STE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162393",
            "telephone_number": "651-293-1497",
            "fax_number": "763-717-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 MONTREAL AVE STE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "651-293-1497",
            "fax_number": "763-717-2988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 Coon Rapids Blvd NW",
            "address_2": "Suite 315",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335831",
            "country_code": "US",
            "telephone_number": "763-717-9510",
            "fax_number": "763-717-2988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "199 Coon Rapids Blvd NW",
            "address_2": "Suite 315",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335831",
            "country_code": "US",
            "telephone_number": "763-717-9510",
            "fax_number": "763-717-2988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLTE",
        "first_name": "RYAN",
        "middle_name": "W.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-21",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.