Individual provider Active NPI

Kelley Lumbard, DC

  • Chiropractor
  • Eagan, MN
National Provider Identifier
1184055873
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6232 Issued in MN
Practice address
1519 Central Pkwy Ste 260
Eagan, MN 55121-2488
Phone
(612) 578-6001
NPI assigned
Dec 5, 2013
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6232 MN Primary

Addresses

Primary practice location

1519 Central Pkwy Ste 260
Eagan, MN 55121-2488

Mailing address

4616 Black Wolf Run
Eagan, MN 55123-3400
Phone (612) 578-6001

Other practice location 1

2025 4th St
White Bear Lake, MN 55110-2762
Phone (651) 210-5261

Other practice location 2

968 Grand Ave
Saint Paul, MN 55105-3014
Phone (651) 210-5261

Other names 1

  • Dr. Kelley Schams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6232MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Company - Greenfield West LLC Chiropractor CurrentSince Jul 19, 2022 Accepting new patients

Locations

6278 S 108th St
Hales Corners, WI 53130
Phone (414) 235-8740

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, 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": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1184055873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 BLACK WOLF RUN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551233400",
            "telephone_number": "612-578-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 CENTRAL PKWY STE 260",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212488",
            "telephone_number": "612-578-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 4th St",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551102762",
            "country_code": "US",
            "telephone_number": "651-210-5261",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "968 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551053014",
            "country_code": "US",
            "telephone_number": "651-210-5261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUMBARD",
        "first_name": "KELLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "SCHAMS",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.