DR. RYAN WILLIAM WADDELL (D.C.) – Chiropractor, NPI 1063800704

DR. RYAN WILLIAM WADDELL (D.C.) is a healthcare provider. based in Blaine, Minnesota. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 6017 (MN). The NPI Number for DR. RYAN WILLIAM WADDELL (D.C.) is 1063800704

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
DR. RYAN WILLIAM WADDELL (D.C.)
NPI
1063800704
Phone
(763) 400-4940
Address
10995 CLUB WEST PKWY STE 400
Enumeration Date
5 January 2015
Last Update Date
13 January 2015

Doctor Profile

Medical School Name
NORTHWESTERN COLLEGE OF CHIROPRACTIC
Secondary Phone
7634004940
Graduation Year
2014 (12 years ago)
PAC ID
8921326471
Group Practice PAC ID
7416310610
Professional Enrollment ID
I20150413000981
Address ID
MN554493673BL10950PKWY401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

1,642 CHIROPRACTIC in MN

Provider Addresses for DR. RYAN WILLIAM WADDELL (D.C.)

  • 10995 CLUB WEST PKWY STE 400

    BLAINE, MN 554495862

    Phone: (763) 400-4940

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-04-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150413000981IChiropracticMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions10317$0
View full utilization report →

Insurance plans in this area (ZIP 55449)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416310610View full group profile
NameSpecialtyState
C H I R O P R A C T I CMN
C H I R O P R A C T I CWA

Reviews

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Frequently asked questions

Where can patients find DR. RYAN WILLIAM WADDELL (D.C.)'s NPI?
You can confirm DR. RYAN WILLIAM WADDELL (D.C.) with NPI 1063800704; it appears in the national provider directory.
Is DR. RYAN WILLIAM WADDELL (D.C.) currently active in the NPI registry?
CMS-published data lists DR. RYAN WILLIAM WADDELL (D.C.) as an active registrant.
What does DR. RYAN WILLIAM WADDELL (D.C.) treat or focus on?
Patients typically see DR. RYAN WILLIAM WADDELL (D.C.) under the specialty Chiropractor. Clinical services aligned with this taxonomy classification.
Where is DR. RYAN WILLIAM WADDELL (D.C.)'s primary listing?
We display Blaine, Minnesota because that is what the record indicates for DR. RYAN WILLIAM WADDELL (D.C.).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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