Individual provider Active NPI

Lance L Munns, DC

  • Chiropractor
  • Rexburg, ID
National Provider Identifier
1063184158
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-2170 Issued in ID
Practice address
1096 Erikson Dr
Rexburg, ID 83440-5297
Phone
(208) 656-3205
NPI assigned
Sep 28, 2021
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-2170 ID Primary

Addresses

Primary practice location

1096 Erikson Dr
Rexburg, ID 83440-5297

Mailing address

1096 Erikson Dr
Rexburg, ID 83440-5297
Phone (208) 656-3205

Other practice location 1

104 N Bridge St
Saint Anthony, ID 83445-1455
Phone (208) 656-3205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220328000378 ID Practitioner - Chiropractic 3779978895 Practice locations: Rexburg, ID

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1096 Erikson Dr
Rexburb, ID 83440-5297
Phone (208) 656-3205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-2170IDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1063184158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 ERIKSON DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405297",
            "telephone_number": "208-656-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 ERIKSON DR",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405297",
            "telephone_number": "208-656-3205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 N Bridge St",
            "address_purpose": "LOCATION",
            "city": "Saint Anthony",
            "state": "ID",
            "postal_code": "834451455",
            "country_code": "US",
            "telephone_number": "208-656-3205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNNS",
        "first_name": "LANCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.