Individual provider Active NPI

Patrik Ryan Schneider, D.C.

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1619365301
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
076026 Issued in IA
Practice address
1333 W Lombard St Ste D
Davenport, IA 52804-2101
Phone
(563) 388-6364
Fax
(563) 386-1064
NPI assigned
Jan 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 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 076026 IA Primary

Addresses

Primary practice location

1333 W Lombard St Ste D
Davenport, IA 52804-2101

Mailing address

1333 W Lombard St Ste D
Davenport, IA 52804-2101
Phone (563) 388-6364

Other identifiers 1

IdentifierTypeStateIssuer
0706363MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150326002179 IA Practitioner - Chiropractic 7113244369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1333 W Lombard St
Suite D
Davenport, IA 52804-2101
Phone (563) 388-6364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Schneider Chiropractic, LLC Chiropractor CurrentSince Jan 13, 2015 Accepting new patients

Locations

516 W 35th St
Davenport, IA 52806
Phone (563) 388-6364

1333 W Lombard St
Ste D
Davenport, IA 52804
Phone (563) 338-6364

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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1619365301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W LOMBARD ST STE D",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042101",
            "telephone_number": "563-388-6364",
            "fax_number": "563-386-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W LOMBARD ST STE D",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042101",
            "telephone_number": "563-388-6364",
            "fax_number": "563-386-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "PATRIK",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "076026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0706363",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

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