Individual provider Active NPI

Ryan A McDonnel, DC

  • Chiropractor
  • Fredericksburg, VA
National Provider Identifier
1427065002
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556359 Issued in VA
Practice address
5705 Salem Run Blvd
Suite 100
Fredericksburg, VA 22407-7119
Phone
(540) 786-4882
Fax
(540) 786-4893
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556359 VA Primary

Addresses

Primary practice location

5705 Salem Run Blvd
Suite 100
Fredericksburg, VA 22407-7119

Mailing address

17470 Center Dr
Suite 4C
Ruther Glen, VA 22546-2881
Phone (804) 448-0887

Other identifiers 1

IdentifierTypeStateIssuer
0104556359OtherVAVA STATE LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050916000689 VA Practitioner - Chiropractic 2365475571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17470 Ctr Dr
Suite 4C
Ruther Glen, VA 22546-2881
Phone (804) 448-0887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McDonnel LLC Chiropractor CurrentSince Nov 24, 2009 Accepting new patients
Asimacopoulos, LLC Chiropractor Past Accepting new patients
Bea, LLC Chiropractor Past Accepting new patients

Locations

17470 Center Dr
Ste 4C
Ruther Glen, VA 22546
Phone (804) 448-0887

Organizations & group practices 3

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1427065002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17470 CENTER DR",
            "address_2": "SUITE 4C",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225462881",
            "telephone_number": "804-448-0887",
            "fax_number": "804-448-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 SALEM RUN BLVD",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224077119",
            "telephone_number": "540-786-4882",
            "fax_number": "540-786-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNEL",
        "first_name": "RYAN",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STATE LICENSE NUMBER",
            "identifier": "0104556359",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.