Active NPI
Ryan Edward Dertinger, DC
- Chiropractor
- Platte City, MO
National Provider Identifier
1720580061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 090090
- Practice address
- 700 Branch St Ste 10
Platte City, MO 64079-9298 - Phone
- (816) 232-5113
- NPI assigned
- Mar 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 090090 | IA | Primary |
Addresses
Primary practice location
700 Branch St Ste 10
Platte City, MO 64079-9298
Mailing address
62 Crestwood Ter
Davenport, IA 52803-3719
Phone (847) 630-7567
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090090 | IA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Armed Forces Chiropractic | Chiropractor | Current | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519948800000",
"number": "1720580061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 CRESTWOOD TER",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528033719",
"telephone_number": "847-630-7567",
"fax_number": "847-630-7567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 BRANCH ST STE 10",
"city": "PLATTE CITY",
"state": "MO",
"postal_code": "640799298",
"telephone_number": "816-232-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERTINGER",
"first_name": "RYAN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-02",
"last_updated": "2018-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "090090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Platte City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.