Individual provider Active NPI

Laura K Barry, D.C.

  • Chiropractor
  • Lakeville, MN
National Provider Identifier
1053447987
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4674 Issued in MN
Practice address
16283 Ipava Ave
Lakeville, MN 55044-4658
Phone
(952) 898-2287
Fax
(952) 898-3287
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4674 MN Primary

Addresses

Primary practice location

16283 Ipava Ave
Lakeville, MN 55044-4658

Mailing address

798 Watson Ave
Saint Paul, MN 55102-3918
Phone (651) 224-5887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140217000717 IL Practitioner - Chiropractic 6709971732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weber Micetich Chiropractic PCGroup PAC ID 9830113158, 2 clinicians

Practice addresses (Care Compare)

24 E N St
Coal City, IL 60416-1087
Phone (815) 634-0445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4674MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Weber Micetich Chiropractic P.C. Chiropractor CurrentSince Dec 10, 2016 Accepting new patients

Locations

24 E North St
Coal City, IL 60416
Phone (815) 634-0445

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053447987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 WATSON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023918",
            "telephone_number": "651-224-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16283 IPAVA AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444658",
            "telephone_number": "952-898-2287",
            "fax_number": "952-898-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "LAURA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.