Individual provider Active NPI

Dustin E Ridgway, DC

  • Chiropractor
  • Durango, CO
National Provider Identifier
1770649774
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR-6720 Issued in CO
Practice address
3473 Main Ave Ste 15
Durango, CO 81301-4040
Phone
(970) 247-5519
Fax
(970) 382-8457
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR-6720 CO Primary

Addresses

Primary practice location

3473 Main Ave Ste 15
Durango, CO 81301-4040

Mailing address

3473 Main Ave Ste 15
Durango, CO 81301-4040
Phone (970) 247-5519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120424000392 CO Practitioner - Chiropractic 4284739442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

129 E 32ND St
Durango, CO 81301-4232
Phone (970) 247-5519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHR-6720COMDChiropractor
3656OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Durango Chiropractic Clinic Chiropractor CurrentSince Jan 1, 2012 Accepting new patients
Wood Chiropratic Inc. Chiropractor PastSince May 13, 2010 Accepting new patients

Locations

3473 Main Ave
Ste 15
Durango, CO 81301
Phone (970) 247-5519

129 E 32nd St
Durango, CO 81301
Phone (970) 247-5519

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1770649774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3473 MAIN AVE STE 15",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014040",
            "telephone_number": "970-247-5519",
            "fax_number": "970-382-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3473 MAIN AVE STE 15",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014040",
            "telephone_number": "970-247-5519",
            "fax_number": "970-382-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGWAY",
        "first_name": "DUSTIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR-6720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.