Individual provider Active NPI

Ryan A O'Bleness, D.C.

  • Chiropractor
  • Simpsonville, SC
National Provider Identifier
1962527291
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2503 Issued in SC
Practice address
655 Fairview Rd
Suite J
Simpsonville, SC 29680-7500
Phone
(864) 962-8800
Fax
(864) 228-9129
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH2503 SC Primary

Addresses

Primary practice location

655 Fairview Rd
Suite J
Simpsonville, SC 29680-7500

Mailing address

655 Fairview Rd
Ste J
Simpsonville, SC 29680-6777
Phone (864) 962-8800

Other identifiers 2

IdentifierTypeStateIssuer
20-0873179OtherSCFED TAX ID
CH2503MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040204000878 SC Practitioner - Chiropractic 7810880705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

680 Fairview Rd
Suite D
Simpsonville, SC 29680-6789
Phone (864) 962-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH2503SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Simpsonville Family Chiropractic, Inc. Chiropractor CurrentSince Dec 1, 2003 Accepting new patients

Locations

655 Fairview Rd
Ste J
Simpsonville, SC 29680
Phone (864) 962-8800

680 Fairview Rd
Ste D
Simpsonville, SC 29680
Phone (864) 962-8800

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1962527291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 FAIRVIEW RD",
            "address_2": "STE J",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806777",
            "telephone_number": "864-962-8800",
            "fax_number": "864-228-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 FAIRVIEW RD",
            "address_2": "SUITE J",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807500",
            "telephone_number": "864-962-8800",
            "fax_number": "864-228-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BLENESS",
        "first_name": "RYAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "CH2503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "20-0873179",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2503",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.