Active NPI
Tred J Rissacher, DC
- Chiropractor
- Stuart, FL
National Provider Identifier
1619023033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH7105
- Practice address
- 2311 SE Federal Hwy
Stuart, FL 34994 - Phone
- (772) 219-8300
- Fax
- (772) 219-3303
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH7105 | FL | Primary |
Addresses
Primary practice location
2311 SE Federal Hwy
Stuart, FL 34994
Mailing address
2311 SE Federal Hwy
Stuart, FL 34994
Phone (772) 219-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89043 | Other | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CH7105 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619023033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2311 SE FEDERAL HWY",
"city": "STUART",
"state": "FL",
"postal_code": "34994",
"telephone_number": "772-219-8300",
"fax_number": "772-219-3303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2311 SE FEDERAL HWY",
"city": "STUART",
"state": "FL",
"postal_code": "34994",
"telephone_number": "772-219-8300",
"fax_number": "772-219-3303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISSACHER",
"first_name": "TRED",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH7105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "89043",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
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.