Individual provider Active NPI

Ryan Joseph Vidrine, DC

  • Chiropractor
  • Lafayette, LA
National Provider Identifier
1407994320
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1284 Issued in LA
Practice address
326 Settlers Trace Blvd # 201-C
Lafayette, LA 70508-6091
Phone
(337) 270-0900
Fax
(337) 270-0901
NPI assigned
Feb 2, 2007
Last updated
Aug 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1284 LA Primary

Addresses

Primary practice location

326 Settlers Trace Blvd # 201-C
Lafayette, LA 70508-6091

Mailing address

326 Settlers Trace Blvd # 201-C
Lafayette, LA 70508-6091
Phone (337) 270-0900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151022000927 LA Practitioner - Chiropractic 8123337748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

326 Settlers Trace Blvd
Lafayette, LA 70508-6091
Phone (337) 270-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1284LAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan J Vidrine LLC Chiropractor CurrentSince Aug 31, 2021 Accepting new patients
The Barczyk Clinic Chiropractor CurrentSince Feb 24, 2015 Accepting new patients
Hargrave Chiropractic LLC Chiropractor Past Accepting new patients
Franklin Chiropractic Clinic, Incorporated Chiropractor PastSince Aug 9, 2004 Accepting new patients
C, Michelle Didier, DC, LLC Chiropractor Past Accepting new patients

Locations

1721 W Pinhook Rd
Lafayette, LA 70508
Phone (337) 266-9949

204 Petroleum Dr
Lafayette, LA 70508
Phone (337) 266-9949

326 Settlers Trace Blvd
#20
Lafayette, LA 70508
Phone (337) 270-0900

326 Settlers Trace Blvd
#201C
Lafayette, LA 70508
Phone (337) 270-0900

326 Settlers Trace Blvd
Ste 201
Lafayette, LA 70508

724 S Lewis St
New Iberia, LA 70560
Phone (337) 369-7011

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1407994320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 SETTLERS TRACE BLVD # 201-C",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086091",
            "telephone_number": "337-270-0900",
            "fax_number": "337-270-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 SETTLERS TRACE BLVD # 201-C",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086091",
            "telephone_number": "337-270-0900",
            "fax_number": "337-270-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.