Individual provider Active NPI

Sandra Riediger, DC

  • Chiropractor
  • Santa Monica, CA
National Provider Identifier
1447367412
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17801 Issued in CA
Practice address
2901 Ocean Park Blvd
#207
Santa Monica, CA 90405
Phone
(310) 396-2245
Fax
(310) 396-6736
NPI assigned
Aug 24, 2006
Last updated
Oct 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC17801 CA Primary

Addresses

Primary practice location

2901 Ocean Park Blvd
#207
Santa Monica, CA 90405

Mailing address

2901 Ocean Park Blvd
#207
Santa Monica, CA 90405
Phone (310) 396-2245

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000277 CA Practitioner - Chiropractic 1759555311 Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2901 Ocean Park Blvd
Suite 207
Santa Monica, CA 90405-2964
Phone (310) 396-2245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC17801CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Courtney Mizuhara-Cheng, D.O., M.S.H.S., Inc. PastSince Jul 17, 2016 Accepting new patients

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, 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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1447367412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 OCEAN PARK BLVD",
            "address_2": "#207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90405",
            "telephone_number": "310-396-2245",
            "fax_number": "310-396-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 OCEAN PARK BLVD",
            "address_2": "#207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90405",
            "telephone_number": "310-396-2245",
            "fax_number": "310-396-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDIGER",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.