Individual provider Active NPI

Andy Lane Minor, DC

  • Chiropractor
  • Blue Springs, MO
National Provider Identifier
1174642748
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2005001169 Issued in MO
Practice address
801 W Main St
Blue Springs, MO 64015-3707
Phone
(816) 228-5522
Fax
(816) 220-0205
NPI assigned
Mar 28, 2007
Last updated
Feb 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2005001169 MO Primary

Addresses

Primary practice location

801 W Main St
Blue Springs, MO 64015-3707

Mailing address

801 W Main St
Blue Springs, MO 64015-3707
Phone (816) 228-5522

Other identifiers 1

IdentifierTypeStateIssuer
35144011OtherMOBCBS-KC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000370 MO Practitioner - Chiropractic 3375590375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andy Minor Chiropractic PCGroup PAC ID 2769439751, 2 clinicians

Practice addresses (Care Compare)

801 W Main St
Blue Springs, MO 64015-3707
Phone (816) 228-5522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005001169MOMDChiropractor

Organizations & group practices 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1174642748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W MAIN ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153707",
            "telephone_number": "816-228-5522",
            "fax_number": "816-220-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAIN ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153707",
            "telephone_number": "816-228-5522",
            "fax_number": "816-220-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "ANDY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2005001169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-KC",
            "identifier": "35144011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.