Individual provider Active NPI

Ryan A Elton, DC

  • Chiropractor
  • Wayzata, MN
National Provider Identifier
1376638403
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3894 Issued in MN
Practice address
1421 Wayzata Blvd
Suite 100
Wayzata, MN 55391-1939
Phone
(952) 473-9637
Fax
(952) 473-1850
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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 3894 MN Primary

Addresses

Primary practice location

1421 Wayzata Blvd
Suite 100
Wayzata, MN 55391-1939

Mailing address

1421 Wayzata Blvd
Suite 100
Wayzata, MN 55391-1939
Phone (952) 473-9637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111010000413 MN Practitioner - Chiropractic 4486826765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
May accept Medicare assignment
Group practices
The Brost Clinic, PAGroup PAC ID 8527049956, 5 clinicians

Practice addresses (Care Compare)

1421 Wayzata Blvd
Suite 100
Wayzata, MN 55391-4103
Phone (952) 473-9637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3894MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Brost Clinic, PA Chiropractor CurrentSince Oct 1, 2000 Accepting new patients

Locations

1421 Wayzata Blvd
Ste 100
Wayzata, MN 55391
Phone (952) 473-9637

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1376638403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 WAYZATA BLVD",
            "address_2": "SUITE 100",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911939",
            "telephone_number": "952-473-9637",
            "fax_number": "952-473-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 WAYZATA BLVD",
            "address_2": "SUITE 100",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911939",
            "telephone_number": "952-473-9637",
            "fax_number": "952-473-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELTON",
        "first_name": "RYAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.