Individual provider Active NPI

Gregory Dean Lettman, D.C.

  • Chiropractor
  • Dubuque, IA
National Provider Identifier
1114960226
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06539 Issued in IA
Practice address
2095 John F Kennedy Rd
Dubuque, IA 52002-3899
Phone
(563) 588-9200
Fax
(563) 583-6594
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06539 IA Primary

Addresses

Primary practice location

2095 John F Kennedy Rd
Dubuque, IA 52002-3899

Mailing address

2095 John F Kennedy Rd
Dubuque, IA 52002-3899
Phone (563) 588-9200

Other identifiers 2

IdentifierTypeStateIssuer
1266155MedicaidIA
09750OtherIABLUECROSS/BLUESHIELDS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060916000067 IA Practitioner - Chiropractic 3173528635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lettman Chiropractic Rehab CareGroup PAC ID 9638174196, 3 clinicians

Practice addresses (Care Compare)

2095 John F Kennedy Rd
Suite 3
Dubuque, IA 52002-3899
Phone (563) 588-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06539IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lettman Chiropractic Rehab Care Chiropractor CurrentSince May 1, 2006 Accepting new patients
Chiropractic Rehab Center, PC Chiropractor PastSince Jun 16, 2024 Accepting new patients

Locations

2095 John F Kennedy Rd
Ste 3
Dubuque, IA 52002
Phone (563) 588-9200

2095 John F Kennedy Rd
Dubuque, IA 52002
Phone (563) 557-1111

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1114960226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 JOHN F KENNEDY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023899",
            "telephone_number": "563-588-9200",
            "fax_number": "563-583-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 JOHN F KENNEDY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520023899",
            "telephone_number": "563-588-9200",
            "fax_number": "563-583-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTMAN",
        "first_name": "GREGORY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1266155",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELDS",
            "identifier": "09750",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.