Individual provider Active NPI

Ricky Reich Sides, DC

  • Chiropractor
  • Winston Salem, NC
National Provider Identifier
1992792337
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1218 Issued in NC
Practice address
1570 Westbrook Plaza Dr
Winston-Salem, NC 27103-1328
Phone
(386) 774-0209
Fax
(336) 774-0905
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1218 NC Primary

Addresses

Primary practice location

1570 Westbrook Plaza Dr
Winston-Salem, NC 27103-1328

Mailing address

1570 Westbrook Plaza Dr
Winston-Salem, NC 27103-1328
Phone (386) 774-0209

Other identifiers 2

IdentifierTypeStateIssuer
08791OtherBLUE CROSS BS
890252LMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080328000176 NC Practitioner - Chiropractic 4082507637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1570 Westbrook Plaza Dr
Winston Salem, NC 27103-1328
Phone (336) 774-0209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1218NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sides Chiropractic PA Chiropractor CurrentSince Feb 17, 1998 Accepting new patients

Locations

1570 Westbrook Plaza Dr
Winston Salem, NC 27103
Phone (336) 774-0209

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1992792337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 WESTBROOK PLAZA DR",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271031328",
            "telephone_number": "386-774-0209",
            "fax_number": "336-774-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 WESTBROOK PLAZA DR",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271031328",
            "telephone_number": "386-774-0209",
            "fax_number": "336-774-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDES",
        "first_name": "RICKY",
        "middle_name": "REICH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BS",
            "identifier": "08791",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890252L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.