Individual provider Active NPI

Ryan Grenier, DC

  • Chiropractor
  • Wichita, KS
National Provider Identifier
1508418914
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05986 Issued in KS
Practice address
3017 N Cypress St Ste B
Wichita, KS 67226-4026
Phone
(316) 425-1911
NPI assigned
Jul 15, 2019
Last updated
May 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05986 KS Primary

Addresses

Primary practice location

3017 N Cypress St Ste B
Wichita, KS 67226-4026

Mailing address

1122 N Spring Ridge CT
Derby, KS 67037-1300
Phone (316) 371-5623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190906000812 KS Practitioner - Chiropractic 0042549602 Reassigns benefits to 1 organization
Practice locations: Wichita, KS

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3017 N Cypress St
Suite B
Wichita, KS 67226-4026
Phone (316) 425-1911

3017 N Cypress St B
Optimal Wellness
Wichita, KS 67226-4026
Phone (316) 425-1911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05986KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Grenier LLC Chiropractor CurrentSince Mar 1, 2020 Accepting new patients
Optimal Wellness LLC Chiropractor PastSince Jul 25, 2019 Accepting new patients

Locations

3017 N Cypress St
Ste B
Wichita, KS 67226
Phone (316) 425-1911

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1508418914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 N SPRING RIDGE CT",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670371300",
            "telephone_number": "316-371-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 N CYPRESS ST STE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264026",
            "telephone_number": "316-425-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENIER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.