Individual provider Active NPI

Ryan McCafferty, DC

  • Chiropractor
  • Fairview Heights, IL
National Provider Identifier
1619673480
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013954 Issued in IL
Practice address
10513 Lincoln TRL
Fairview Heights, IL 62208-1911
Phone
(618) 398-7550
NPI assigned
Feb 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013954 IL Primary

Addresses

Primary practice location

10513 Lincoln TRL
Fairview Heights, IL 62208-1911

Mailing address

8020 Grandvista Ave
Saint Louis, MO 63123-2606
Phone (314) 562-1841

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038.013954ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Limitless Chiropractic LLC Chiropractor CurrentSince Feb 8, 2023 Accepting new patients
Michael K. Faulkner DC Chiropractor PastSince Feb 8, 2023 Accepting new patients

Locations

10513 Lincoln Trl
Fairview Hts, IL 62208
Phone (618) 398-7550

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1619673480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 GRANDVISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631232606",
            "telephone_number": "314-562-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 LINCOLN TRL",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081911",
            "telephone_number": "618-398-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFERTY",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.