Dockter - Lutz Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3573 Issued in MN

Legal business name

DOCKTER - LUTZ CHIROPRACTIC, LLC

Doing business as

Pine City Family Chiropractic

Practice address

620 Civic Heights Dr
Suite 108
Circle Pines, MN 55014-4711

Phone

(763) 795-8300

Fax

(763) 795-8302

NPI assigned

Sep 26, 2006

Last updated

Aug 7, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maria L Skotterud

Title

Director of Human Resources

Phone

(763) 795-8300

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Pine City Family Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher Allen Dockter, DC

  • Chiropractor
  • Pine City, MN
  • NPI 1205838869
  Medicare reassignment NPD
• Daniel Simeon Lutz, DC

  • Chiropractor
  • Circle Pines, MN
  • NPI 1255333845
  NPD
• Daniel Gerald Moore, DC

  • Chiropractor
  • Elk River, MN
  • NPI 1285636845
  NPD (past)
• Jeremie Schwartz

  • Chiropractor
  • Minneapolis, MN
  • NPI 1740660182
  NPD (past)
• Christopher James Slice

  • Chiropractor
  • Big Lake, MN
  • NPI 1548466113
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1093816258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CIVIC HEIGHTS DR",
            "address_2": "SUITE 108",
            "city": "CIRCLE PINES",
            "state": "MN",
            "postal_code": "550144711",
            "telephone_number": "763-795-8300",
            "fax_number": "763-795-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CIVIC HEIGHTS DR",
            "address_2": "SUITE 108",
            "city": "CIRCLE PINES",
            "state": "MN",
            "postal_code": "550144711",
            "telephone_number": "763-795-8300",
            "fax_number": "763-795-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCKTER - LUTZ CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "SKOTTERUD",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF HUMAN RESOURCES",
        "authorized_official_telephone_number": "763-795-8300"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3400",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3433",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VAUGHN N REENTS NPI",
            "identifier": "1932216249",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DANIEL S LUTZ NPI",
            "identifier": "1255333845",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHRISTOPHER A DOCKTER NPI",
            "identifier": "1205838869",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine City Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Corcoran
• Paul David Craven, DDS
• Kristine Marie Davies
• Roger J. Day, M.D.
• Diagnostic Radiology Consultants
• Jamie Dawn Dolieslager, DAT, ATC, LAT
• Andy Droel, DDS
• Natalie Droel, DDS
• Linnea Campbell Dumke, LICSW
• Hoda M Fahim

• Chiropractor in Circle Pines, MN
• Providers in Circle Pines, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.