Individual provider Active NPI

Ryan T Schrock, D.C.

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1790210391
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
COCHR0007348 Issued in CO
Practice address
300 Nickel St Ste 9
Broomfield, CO 80020-2097
Phone
(303) 386-3696
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X COCHR0007348 CO Primary

Addresses

Primary practice location

300 Nickel St Ste 9
Broomfield, CO 80020-2097

Mailing address

101 Cedar Rock Trce
Athens, GA 30605-7701
Phone (706) 548-8984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422000017 CO Practitioner - Chiropractic 3870017635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Nickel St
Suite 9
Broomfield, CO 80020-2097
Phone (303) 386-3696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COCHR0007348COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Alive Chiropractic LLC Chiropractor CurrentSince May 1, 2025 Accepting new patients

Locations

300 Nickel St
Ste 9
Broomfield, CO 80020
Phone (303) 386-3696

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1790210391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CEDAR ROCK TRCE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306057701",
            "telephone_number": "706-548-8984",
            "fax_number": "170-638-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NICKEL ST STE 9",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202097",
            "telephone_number": "303-386-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROCK",
        "first_name": "RYAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "COCHR0007348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.