Individual provider Active NPI

Ryan D De Rosales, DC

  • Chiropractor
  • Toledo, OH
National Provider Identifier
1992479091
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-05384 Issued in OH
Practice address
2735 N Holland Sylvania Rd Ste B1
Toledo, OH 43615-1844
Phone
(419) 930-6607
Fax
(419) 517-4076
NPI assigned
Aug 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013749 IL
Chiropractor 111N00000X DC-05384 OH Primary

Addresses

Primary practice location

2735 N Holland Sylvania Rd Ste B1
Toledo, OH 43615-1844

Mailing address

2735 N Holland Sylvania Rd Ste B1
Toledo, OH 43615-1844
Phone (419) 930-6607

Other practice location 1

1010 Harlem Rd
Machesney Park, IL 61115-2518
Phone (815) 654-1044

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
038.013749ILMDChiropractor
DC-05384OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Chiropractic Center, LLC Chiropractor CurrentSince Jul 9, 2024 Accepting new patients
Martin J Adams DC PC Inc Chiropractor PastSince Oct 11, 2024 Accepting new patients
James P. Hulsebus Chiropractor PastSince Aug 1, 2021 Accepting new patients

Locations

2735 N Holland Sylvania Rd
Ste B1
Toledo, OH 43615
Phone (419) 531-7818

Organizations & group practices 3

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1992479091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 N HOLLAND SYLVANIA RD STE B1",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151844",
            "telephone_number": "419-930-6607",
            "fax_number": "419-517-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 N HOLLAND SYLVANIA RD STE B1",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151844",
            "telephone_number": "419-930-6607",
            "fax_number": "419-517-4076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Harlem Rd",
            "address_purpose": "LOCATION",
            "city": "Machesney Park",
            "state": "IL",
            "postal_code": "611152518",
            "country_code": "US",
            "telephone_number": "815-654-1044",
            "fax_number": "815-639-3529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE ROSALES",
        "first_name": "RYAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-03",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013749",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC-05384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.