Individual provider Active NPI

Ryan Wayne House, D.C.

  • Chiropractor
  • Lebanon, TN
National Provider Identifier
1891732517
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2103 Issued in TN
Practice address
1633 W Main St
#401
Lebanon, TN 37087-3423
Phone
(615) 444-2234
Fax
(615) 547-4849
NPI assigned
Jun 1, 2006
Last updated
Mar 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2103 TN Primary

Addresses

Primary practice location

1633 W Main St
#401
Lebanon, TN 37087-3423

Mailing address

1633 W Main St
#401
Lebanon, TN 37087-3423
Phone (615) 444-2234

Other identifiers 1

IdentifierTypeStateIssuer
3734252OtherTNMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060802000397 TN Practitioner - Chiropractic 5092728394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Cumberland Chiropractic and Sports Medicine, LLCGroup PAC ID 6901042597, 2 clinicians

Practice addresses (Care Compare)

1633 W Main St
Suite 401
Lebanon, TN 37087-7804
Phone (615) 444-2234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2103TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Chiropractic and Sports Medicine, LLC Chiropractor CurrentSince Feb 1, 2013 Accepting new patients
In Motion Spine & Joint Center, Inc. Chiropractor PastSince Mar 27, 2006 Accepting new patients

Locations

1416 W Main St
Ste H
Lebanon, TN 37087
Phone (615) 444-2234

1633 W Main St
Ste 401
Lebanon, TN 37087
Phone (615) 444-2234

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1891732517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 W MAIN ST",
            "address_2": "#401",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873423",
            "telephone_number": "615-444-2234",
            "fax_number": "615-547-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 W MAIN ST",
            "address_2": "#401",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873423",
            "telephone_number": "615-444-2234",
            "fax_number": "615-547-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "RYAN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "3734252",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.