Ryan Edward Zaidel, D.C. – Chiropractor

Key facts

NPI: 1407092893
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 5183 (MN)
Practice address: 47 N Waterville Ave
Le Center, MN 56057-1522
Phone: (952) 484-7738
NPI assigned: Jan 6, 2009
Sex: Male
Sole proprietor: No

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.

Priority Health Chiropractic Clinic Chiropractor · Le Center, MN · NPI 1255563920

NPD (past) Authorized official CHIROPRACTOR

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
5183	MN	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Priority Health Chiropractic Clinic	Chiropractor	Past since Jul 10, 2009	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	5183	MN	Yes

Addresses

Primary practice location

47 N Waterville Ave
Le Center, MN 56057-1522

Mailing address

47 N Waterville Ave
Le Center, MN 56057-1522
Phone (952) 484-7738

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 8, 2009.

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241740800000",
    "number": "1407092893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N WATERVILLE AVE",
            "city": "LE CENTER",
            "state": "MN",
            "postal_code": "560571522",
            "telephone_number": "952-484-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 N WATERVILLE AVE",
            "city": "LE CENTER",
            "state": "MN",
            "postal_code": "560571522",
            "telephone_number": "952-484-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAIDEL",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Center, MN

All providers in Le Center, MN · Chiropractor in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.