Individual provider Active NPI

William Dean Ryckman, D.C.

  • Chiropractor
  • Flint, MI
National Provider Identifier
1447393269
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004058 Issued in MI
Practice address
5154 Miller Rd
Suite J
Flint, MI 48507-1065
Phone
(810) 733-0310
Fax
(810) 733-5554
NPI assigned
Feb 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004058 MI Primary

Addresses

Primary practice location

5154 Miller Rd
Suite J
Flint, MI 48507-1065

Mailing address

5154 Miller Rd
Suite J
Flint, MI 48507-1065
Phone (810) 733-0310

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004058MIMDChiropractor

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447393269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5154 MILLER RD",
            "address_2": "SUITE J",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071065",
            "telephone_number": "810-733-0310",
            "fax_number": "810-733-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5154 MILLER RD",
            "address_2": "SUITE J",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071065",
            "telephone_number": "810-733-0310",
            "fax_number": "810-733-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYCKMAN",
        "first_name": "WILLIAM",
        "middle_name": "DEAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.