Individual provider Active NPI

Bryan Gasper Ruocco, DC

  • Chiropractor
  • Rocky River, OH
National Provider Identifier
1942394705
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3913 Issued in OH
Practice address
21690 River Oaks Dr
Rocky River, OH 44116-3108
Phone
(440) 331-4744
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3424 NC
Chiropractor 111N00000X CH8816 FL
Chiropractor 111N00000X 3913 OH Primary

Addresses

Primary practice location

21690 River Oaks Dr
Rocky River, OH 44116-3108

Mailing address

21690 River Oaks Dr
Rocky River, OH 44116-3108
Phone (440) 331-4744

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000285 OH Practitioner - Chiropractic 4385651850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21690 River Oaks Dr
Rocky River, OH 44116-3108
Phone (440) 331-4744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH8816FLMDChiropractor
3913OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adjusting the World Chiropractic P.C. Chiropractor Past Accepting new patients
Dan G Tubbs Chiropractor PastSince Jul 11, 2015 Accepting new patients
Rodsater Family Chiropractic PLLC PastSince Nov 21, 2010 Accepting new patients
Tubbs Chiropractic LLC Chiropractor PastSince Sep 3, 2012 Accepting new patients

Organizations & group practices 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1942394705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21690 RIVER OAKS DR",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163108",
            "telephone_number": "440-331-4744",
            "fax_number": "440-331-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21690 RIVER OAKS DR",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163108",
            "telephone_number": "440-331-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUOCCO",
        "first_name": "BRYAN",
        "middle_name": "GASPER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3424",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8816",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.