NPIMap

Organization Active NPI

River Street Spine Clinic PC

  • Chiropractor
  • Mattapan, MA
National Provider Identifier
1982743431
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2765 Issued in MA
Legal business name
RIVER STREET SPINE CLINIC PC
Practice address
500 River St
Mattapan, MA 02126-2211
Phone
(617) 298-1776
Fax
(617) 298-7366
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ryan Mark Warnock, D.C.NPI 1770664633
Title
Owner and Ceo
Phone
(617) 298-1776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2765 MA Primary

Addresses

Primary practice location

500 River St
Mattapan, MA 02126-2211

Mailing address

500 River St
Mattapan, MA 02126-2211
Phone (617) 298-1776

National Provider Directory

National Provider Directory

Locations

500 River St
Mattapan, MA 02126
Phone (617) 298-1776

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982743431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262211",
            "telephone_number": "617-298-1776",
            "fax_number": "617-298-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262211",
            "telephone_number": "617-298-1776",
            "fax_number": "617-298-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER STREET SPINE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARNOCK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "617-298-1776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.