Jack Ellis Lorenz, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

676 Issued in OH

Practice address

1770 Jefferson Ave
Defiance, OH 43512

Phone

(419) 782-2250

Fax

(419) 784-2347

NPI assigned

Aug 29, 2006

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 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1083723613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 JEFFERSON AVE",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "43512",
            "telephone_number": "419-782-2250",
            "fax_number": "419-784-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 JEFFERSON AVE",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "43512",
            "telephone_number": "419-782-2250",
            "fax_number": "419-784-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "JACK",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000119614",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0340885",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine A Liebrecht, PHARMD
• Alicia Little, D.C.
• Emily S Logston
• Tamar Lomeli, RN
• Aleea Lonabarger
• William David Lorenz, DC
• Jessica Lowe, CDCA
• Monica Kay Lowe
• Danielle Lucas, M.A., CCC/SLP
• Joshua Michael Lucas, M.D.

• Chiropractor in Defiance, OH
• Providers in Defiance, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.