Shawn Conrad Lutz, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

4064 Issued in OR

Practice address

2955 N Hwy 97 Ste 100
Bend, OR 97703-7559

Phone

(458) 206-6123

Fax

(541) 600-4731

NPI assigned

Feb 11, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawn Lutz DC LLCGroup PAC ID 3375970395, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shawn Lutz DC LLC

  dba Dynamic Sports Rehab

  • Sports Physician Chiropractor
  • Bend, OR
  • NPI 1962902403
  Medicare reassignment Care Compare group Authorized official
• Athletes Performance Center PS

  dba Kinetic Sports Rehab

  • Sports Physician Chiropractor
  • Seattle, WA
  • NPI 1013200492
  NPD (past)

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093012999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 N HWY 97 STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037559",
            "telephone_number": "458-206-6123",
            "fax_number": "541-600-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 N HWY 97 STE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037559",
            "telephone_number": "458-206-6123",
            "fax_number": "541-600-4731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 36th St",
            "address_2": "Suite 430",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981038868",
            "country_code": "US",
            "telephone_number": "206-547-0707",
            "fax_number": "206-420-5386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "SHAWN",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CHIR.CH.60226450",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "4064",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "4064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Valentine Luttropp
• David Joseph Lutz, DC
• Emily Elizabeth Lutz
• Jon E Lutz, MD
• Robbie Dee Lutz, LMT.
• Megan Kathleen Lux
• Kathryn Lyman, CHW
• Alison Lynch Miller, MD
• Karlee Lyne
• Karen N. Lynn, M.D.

• Sports Physician Chiropractor in Bend, OR
• Providers in Bend, OR by specialty
• Sports Physician Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.