Individual provider Active NPI

Ryan Timothy Martin, D.C.

  • Chiropractor
  • Kearney, NE
National Provider Identifier
1467825372
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1862 Issued in NE
Practice address
317 W 11TH St
Kearney, NE 68845-7331
Phone
(308) 698-0525
NPI assigned
Nov 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1862 NE Primary

Addresses

Primary practice location

317 W 11TH St
Kearney, NE 68845-7331

Mailing address

317 W 11TH St
Kearney, NE 68845-7331
Phone (308) 698-0525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118001420 NE Practitioner - Chiropractic 0042510364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

317 W 11TH St
Kearney, NE 68845-7331
Phone (308) 698-0525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1862NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Martin Chiropractic LLC Chiropractor CurrentSince Nov 4, 2015 Accepting new patients

Locations

317 W 11th St
Kearney, NE 68845
Phone (308) 698-0525

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.

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1467825372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W 11TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688457331",
            "telephone_number": "308-698-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W 11TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688457331",
            "telephone_number": "308-698-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "RYAN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.