Individual provider Active NPI

Lee Daniel Malmstrom, D.C.

  • Chiropractor
  • Spencer, IA
National Provider Identifier
1124187117
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007136 Issued in IA
Practice address
1025 5TH Ave SE
Spencer, IA 51301-6004
Phone
(712) 580-3294
Fax
(888) 834-8986
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007136 IA Primary

Addresses

Primary practice location

1025 5TH Ave SE
Spencer, IA 51301-6004

Mailing address

1025 5TH Ave SE
Spencer, IA 51301-6004
Phone (712) 580-3294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090428000159 IA Practitioner - Chiropractic 9133129653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Chiropractic and Wellness Center PCGroup PAC ID 9739302761, 2 clinicians

Practice addresses (Care Compare)

1025 5TH Ave SE
Spencer, IA 51301-6004
Phone (712) 580-3294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Chiropractic & Wellness Center PC Chiropractor CurrentSince Mar 6, 2014 Accepting new patients
Lifetime Chiropractic and Wellness PC Chiropractor Past Accepting new patients
Lance E Malmstrom DC, PA Past Accepting new patients
Lifetime Chiropractic Chiropractor Past Accepting new patients

Locations

1025 5th Ave SE
Spencer, IA 51301
Phone (712) 262-3517

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1124187117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 5TH AVE SE",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513016004",
            "telephone_number": "712-580-3294",
            "fax_number": "888-834-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 5TH AVE SE",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513016004",
            "telephone_number": "712-580-3294",
            "fax_number": "888-834-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMSTROM",
        "first_name": "LEE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.