Individual provider Active NPI

Ryan James Effertz

  • Chiropractor
  • Rice Lake, WI
National Provider Identifier
1760614192
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
452412 Issued in WI
Practice address
225 S Main St
Rice Lake, WI 54868-2231
Phone
(715) 234-9876
NPI assigned
Aug 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 452412 WI Primary

Addresses

Primary practice location

225 S Main St
Rice Lake, WI 54868-2231

Mailing address

815 E 9TH St S
Ladysmith, WI 54848-2368
Phone (715) 532-5643

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

LicenseStateTypeSpecialty
452412WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Chiropractic Health Center LLC CurrentSince Feb 1, 2013 Accepting new patients
Stephens Chiropractic, S.C. Chiropractor PastSince Mar 1, 2024 Accepting new patients

Locations

1082 Cedar Cross Rd
Ste 1002
Dubuque, IA 52003
Phone (563) 581-1503

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": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1760614192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E 9TH ST S",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548482368",
            "telephone_number": "715-532-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548682231",
            "telephone_number": "715-234-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFFERTZ",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "452412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.