Individual provider Active NPI

Ryan L Miller, DC

  • Chiropractor
  • Mosinee, WI
National Provider Identifier
1578660965
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4183-012 Issued in WI
Practice address
107 Maple St
Mosinee, WI 54455
Phone
(715) 693-4144
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4183-012 WI Primary

Addresses

Primary practice location

107 Maple St
Mosinee, WI 54455

Mailing address

107 Maple St
Mosinee, WI 54455-1924
Phone (715) 693-4144

Other identifiers 2

IdentifierTypeStateIssuer
38987000OtherWIMEDICAID GROUP
38965200MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060223000509 WI Practitioner - Chiropractic 1759397052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosinee Family Chiropractic SCGroup PAC ID 2567763345, 2 clinicians

Practice addresses (Care Compare)

107 Maple St
Mosinee, WI 54455-1924
Phone (715) 693-4144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4183-012WIMDChiropractor
4183WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mosinee Family Chiropractic SC Chiropractor CurrentSince Dec 31, 2015 Accepting new patients
Allied Health of Wisconsin, SC Chiropractor PastSince Dec 31, 2015 Accepting new patients

Locations

107 Maple St
Mosinee, WI 54455
Phone (715) 693-4144

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1578660965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MAPLE ST",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551924",
            "telephone_number": "715-693-4144",
            "fax_number": "715-692-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MAPLE ST",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "54455",
            "telephone_number": "715-693-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RYAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4183-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "38987000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38965200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mosinee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.