Individual provider Active NPI

Ryan Lyle Villwok, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1972811560
Registry record updated Jun 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1638 Issued in NE
Practice address
625 N 114TH St
Omaha, NE 68154-1514
Phone
(402) 334-1200
NPI assigned
Sep 17, 2010
Last updated
Jun 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 1638 NE Primary

Addresses

Primary practice location

625 N 114TH St
Omaha, NE 68154-1514

Mailing address

625 N 114TH St
Omaha, NE 68154-1514
Phone (402) 334-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110117000050 NE Practitioner - Chiropractic 3577752146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11725 Arbor St
Suite 130
Omaha, NE 68144-2974
Phone (402) 334-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1638NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan L. Villwok, D.C, P.C. Chiropractor CurrentSince Dec 1, 2010 Accepting new patients

Locations

11725 Arbor St
Ste 130
Omaha, NE 68144
Phone (402) 334-1200

625 N 114th St
Omaha, NE 68154
Phone (402) 201-2920

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, 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": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465689600000",
    "number": "1972811560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N 114TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541514",
            "telephone_number": "402-334-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N 114TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541514",
            "telephone_number": "402-334-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLWOK",
        "first_name": "RYAN",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-17",
        "last_updated": "2016-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.