Jeffrey R Lyne, DC

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

2193 Issued in WI

Practice address

1633 W Main St
Sun Prairie, WI 53590-1839

Phone

(608) 837-7712

Fax

(608) 825-6638

NPI assigned

Aug 18, 2005

Last updated

Nov 8, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1023000791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901839",
            "telephone_number": "608-837-7712",
            "fax_number": "608-825-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901839",
            "telephone_number": "608-837-7712",
            "fax_number": "608-825-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNE",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "WI",
            "license": "2193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38797600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Chiropractor in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Orthopedic Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.