Organization Active NPI

New Wave Chiropractic LLC

  • Chiropractor
  • Greenwood, IN
National Provider Identifier
1811569742
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NEW WAVE CHIROPRACTIC LLC
Practice address
997 E County Line Rd Ste U
Greenwood, IN 46143-1076
Phone
(317) 883-9420
Fax
(317) 883-9920
NPI assigned
Jul 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Authorized official

Name
Dr. Mackenzie Ryczek, DCNPI 1659943587
Title
Co Owner
Phone
(317) 883-9420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

997 E County Line Rd Ste U
Greenwood, IN 46143-1076

Mailing address

997 E County Line Rd Ste U
Greenwood, IN 46143-1076
Phone (317) 883-9420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210723001933 IN Part B Supplier - Clinic/Group Practice 1153724430 Receives reassigned benefits from 2 practitioners
Practice locations: Greenwood, IN

National Provider Directory

National Provider Directory

Locations

997 E County Line Rd
Ste U
Greenwood, IN 46143
Phone (317) 883-9420

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1811569742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 E COUNTY LINE RD STE U",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431076",
            "telephone_number": "317-883-9420",
            "fax_number": "317-883-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 E COUNTY LINE RD STE U",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431076",
            "telephone_number": "317-883-9420",
            "fax_number": "317-883-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WAVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "RYCZEK",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "317-883-9420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.