Organization Active NPI

Lancaster Chiropractic LLC

  • Chiropractor
  • Pueblo, CO
National Provider Identifier
1053589820
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5271 Issued in CO
Legal business name
LANCASTER CHIROPRACTIC LLC
Practice address
4736 Eagleridge Cir
Pueblo, CO 81008-2120
Phone
(719) 404-1489
Fax
(719) 545-0642
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Beth Ann Lancaster, DCNPI 1376598862
Title
Owner/Operator
Phone
(719) 404-1489

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5271 CO Primary

Addresses

Primary practice location

4736 Eagleridge Cir
Pueblo, CO 81008-2120

Mailing address

4736 Eagleridge Cir
Pueblo, CO 81008-2120
Phone (719) 404-1489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080313000266 CO Part B Supplier - Clinic/Group Practice 8022193192 Receives reassigned benefits from 2 practitioners
Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory

Locations

4736 Eagleridge Cir
Pueblo, CO 81008
Phone (719) 404-1489

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1053589820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 EAGLERIDGE CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082120",
            "telephone_number": "719-404-1489",
            "fax_number": "719-545-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 EAGLERIDGE CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082120",
            "telephone_number": "719-404-1489",
            "fax_number": "719-545-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LANCASTER",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "719-404-1489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.