Active NPI
Ryan David Haus, DC
- Chiropractor
- Fond Du Lac, WI
National Provider Identifier
1700982659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- WI3392012
- Practice address
- 952 South Park Avenue
Fond Du Lac, WI 54935 - Phone
- (920) 921-9100
- Fax
- (920) 929-0464
- NPI assigned
- Sep 16, 2006
- Last updated
- Jan 6, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | WI3392-012 | WI | |
| Chiropractor | 111N00000X | WI3392012 | WI | Primary |
Addresses
Primary practice location
952 South Park Avenue
Fond Du Lac, WI 54935
Mailing address
952 South Park Avenue
Fond Du Lac, WI 54935
Phone (920) 921-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110114000582 | WI | Practitioner - Chiropractic | 1355530866 | Practice locations: Fond Du Lac, WI |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
952 S Park Ave
Fond Du Lac, WI 54935-8041
Phone (920) 921-9100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WI3392-012 | WI | MD | Chiropractor |
| WI3392012 | WI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vital Life Group Inc | Chiropractor | Current | Accepting new patients |
Locations
952 S Park Ave
Fond du Lac, WI 54935
Phone (920) 921-9100
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, 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": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1700982659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "952 SOUTH PARK AVENUE",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "54935",
"telephone_number": "920-921-9100",
"fax_number": "920-929-0464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "952 SOUTH PARK AVENUE",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "54935",
"telephone_number": "920-921-9100",
"fax_number": "920-929-0464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUS",
"first_name": "RYAN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "WI",
"license": "WI3392-012",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "WI3392012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.