Dr. Shay Ridge LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10568 Issued in FL

Legal business name

DR. SHAY RIDGE LLC

Practice address

405 Seminole Blvd
Largo, FL 33770-3620

Phone

(727) 581-7429

Fax

(727) 581-3199

NPI assigned

Sep 1, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Shay David Ridge, D.C.

Title

Owner Operator Chiropractor

Phone

(727) 581-7429

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1841667219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703620",
            "telephone_number": "727-581-7429",
            "fax_number": "727-581-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703620",
            "telephone_number": "727-581-7429",
            "fax_number": "727-581-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SHAY RIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "RIDGE",
        "authorized_official_first_name": "SHAY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER OPERATOR CHIROPRACTOR",
        "authorized_official_telephone_number": "727-581-7429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "HE005Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.