Ryan Paul

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6090-12 Issued in WI

Practice address

123 W State St
Medford, WI 54451-1772

Phone

(715) 748-4433

NPI assigned

May 9, 2023

Last updated

May 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Borealis Wellness Clinic LLCGroup PAC ID 8123282886, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Borealis Wellness Clinic LLC

  • Clinic/Center
  • Medford, WI
  • NPI 1912279316
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1659061240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W STATE ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511772",
            "telephone_number": "715-748-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W STATE ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511772",
            "telephone_number": "715-748-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6090-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Jean Oestreich, MD
• Richard Lee Olson, DC
• Joel Ryan Oney, DNP, APNP, FNP-BC
• Kelly Marie Orysen, MS CCC- SLP
• Nicole Marie Paul, FNP
• PDQ Medical Transit LLC
• Todd A Peissig, R.PH
• Thomas W Perendy, DPM
• Jessica Pernsteiner
• Tracy Renee Pernsteiner

• Chiropractor in Medford, WI
• Providers in Medford, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.