Ronald W Fritzke, D.C.
Individual provider Active NPI Chiropractor · Mount Shasta, CA
NPI 1710052402 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710052402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC17490 (CA)
- Practice address
- 618 N Mount Shasta Blvd
Mount Shasta, CA 96067-2235 - Phone
- (530) 926-3458
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 1985
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
618 N Mt Shasta Blvd
Mount Shasta, CA 96067-2235
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101111000552 | CA | Practitioner - Chiropractic | 6608061023 | Practice locations: Mount Shasta, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC17490 | CA | MD | Chiropractor |
| 17490 | CA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC17490 | CA | Yes |
Addresses
Primary practice location
618 N Mount Shasta Blvd
Mount Shasta, CA 96067-2235
Mailing address
618 N Mount Shasta Blvd
Mount Shasta, CA 96067-2235
Phone (530) 926-3458
Other providers in Mount Shasta, CA
- Angela Marie Ferrari
- First 5 Siskiyou Children and Families Commission
- Jennifer Fisher
- Tami Foster
- Lindsay Jean Fox
- Jacqueline Michelle Fruttero
- Garfield Beach CVS, L.L.C.
- Gretchen Gerlitz
- Jacqueline Wilkinson Gilbert-Parker
- Gina Renee Palady
All providers in Mount Shasta, CA · Chiropractor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.