Patrick Ryan Rebadow, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5572 Issued in NC

Practice address

1540 E Front St Ste 103
Clayton, NC 27527-6126

Phone

(919) 550-1099

NPI assigned

Jan 6, 2023

Last updated

Jul 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Connected Chiropractic

  • Chiropractor
  • Clayton, NC
  • NPI 1316340441
  Medicare reassignment NPD
• Wellness Way Raleigh LLC

  • Chiropractor
  • Raleigh, NC
  • NPI 1023681483
  NPD (past)

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1316651128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 GARDEN VINE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276108047",
            "telephone_number": "484-529-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E FRONT ST STE 103",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275276126",
            "telephone_number": "919-550-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 Garden Vine Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276108047",
            "country_code": "US",
            "telephone_number": "484-529-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REBADOW",
        "first_name": "PATRICK",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "5572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Clayton, NC
• Providers in Clayton, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.