Organization Active NPI

Lubovich Chiropractic, P.a.

  • Chiropractor
  • Elko, MN
National Provider Identifier
1124231725
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2726 Issued in MN
Legal business name
LUBOVICH CHIROPRACTIC, P.A.
Practice address
730 Main St
Elko, MN 55020-9701
Phone
(952) 461-5110
NPI assigned
May 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Clarence Lubovich, C.D.NPI 1528124005
Title
Owner
Phone
(952) 898-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2726 MN Primary

Addresses

Primary practice location

730 Main St
Elko, MN 55020-9701

Mailing address

10880 175TH CT W Ste 120
Lakeville, MN 55044-7493
Phone (952) 898-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040112000031 MN Part B Supplier - Clinic/Group Practice 3779483318 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lakeville, MN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

730 Main St
New Market, MN 55054
Phone (612) 388-4359

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124231725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10880 175TH CT W STE 120",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447493",
            "telephone_number": "952-898-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MAIN ST",
            "city": "ELKO",
            "state": "MN",
            "postal_code": "550209701",
            "telephone_number": "952-461-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBOVICH CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUBOVICH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-898-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "C.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.