Individual provider Active NPI

Ryan Wilk, D.C.

  • Chiropractor
  • Peoria, AZ
National Provider Identifier
1497161350
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8388 Issued in AZ
Practice address
10200W Happy Valley Rd 135
Peoria, AZ 85383-2879
Phone
(623) 432-2543
NPI assigned
Jul 10, 2014
Last updated
Jul 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 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 8388 AZ Primary

Addresses

Primary practice location

10200W Happy Valley Rd 135
Peoria, AZ 85383-2879

Mailing address

10200W Happy Valley Rd 135
Peoria, AZ 85383-2879
Phone (623) 432-2543

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150522000338 AZ Practitioner - Chiropractic 1658691274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10200 W Happy Valley Pkwy
Suite 135
Peoria, AZ 85383-2879
Phone (623) 335-2471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pyle Family Chiropractic PLLC Chiropractor CurrentSince Jul 15, 2019 Accepting new patients

Locations

10200 W Happy Valley Pkwy
Ste 135
Peoria, AZ 85383
Phone (623) 335-2471

Organizations & group practices 2

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1497161350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200W HAPPY VALLEY RD 135",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832879",
            "telephone_number": "623-432-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200W HAPPY VALLEY RD 135",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832879",
            "telephone_number": "623-432-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILK",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-10",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.