Individual provider Active NPI

Ryan David Groelz, D.C.

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1912124397
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5525 Issued in CO
Practice address
413 Summit Blvd Unit 101
Broomfield, CO 80021-8295
Phone
(303) 499-6565
Fax
(303) 499-8585
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5525 CO Primary

Addresses

Primary practice location

413 Summit Blvd Unit 101
Broomfield, CO 80021-8295

Mailing address

413 Summit Blvd Unit 101
Broomfield, CO 80021-8295
Phone (303) 499-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5525COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Medical Supply Current Accepting new patients

Locations

413 Summit Blvd
Unit 101
Broomfield, CO 80021
Phone (303) 499-6565

Interoperability endpoints

  • Direct secure messaging: ryan.groelz.2@29676.direct.athenahealth.com

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1912124397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 SUMMIT BLVD UNIT 101",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218295",
            "telephone_number": "303-499-6565",
            "fax_number": "303-499-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 SUMMIT BLVD UNIT 101",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218295",
            "telephone_number": "303-499-6565",
            "fax_number": "303-499-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROELZ",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5525",
            "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 19, 2010; 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.