Organization Active NPI

Dr. Ryan Maynard Chiropractic LLC

  • Chiropractor
  • East Point, KY
National Provider Identifier
1841470168
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4712 Issued in KY
Legal business name
DR. RYAN MAYNARD CHIROPRACTIC LLC
Practice address
81 Hager BR Rd
East Point, KY 41216
Phone
(606) 886-3737
Fax
(606) 886-3722
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Authorized official

Name
Dr. Christopher Ryan Maynard, D.C.
Title
Owner
Phone
(606) 886-3737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4712 KY Primary

Addresses

Primary practice location

81 Hager BR Rd
East Point, KY 41216

Mailing address

PO Box 1774
Prestonsburg, KY 41653-5774
Phone (606) 886-3737

Other identifiers 2

IdentifierTypeStateIssuer
000000252597OtherKYBCBS
85002400MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051027000507 KY Part B Supplier - Clinic/Group Practice 2860419074 Receives reassigned benefits from 1 practitioner
Practice locations: East Point, KY

National Provider Directory

National Provider Directory

Locations

81 Hager Br
East Point, KY 41216
Phone (606) 886-3737

781 S Lake Dr
Prestonsburg, KY 41653
Phone (606) 886-3737

Practitioners & affiliated clinicians

Practitioners 1

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": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1841470168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1774",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416535774",
            "telephone_number": "606-886-3737",
            "fax_number": "606-886-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HAGER BR RD",
            "city": "EAST POINT",
            "state": "KY",
            "postal_code": "41216",
            "telephone_number": "606-886-3737",
            "fax_number": "606-886-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RYAN MAYNARD CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-886-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000252597",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.