Organization Active NPI

Richard E. Lizak, D.C., PA

  • Chiropractor
  • Meridian, MS
National Provider Identifier
1194081380
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
476 Issued in MA
Legal business name
RICHARD E. LIZAK, D.C., PA
Practice address
1900 23Rd Ave
Meridian, MS 39301-3107
Phone
(601) 483-6330
Fax
(601) 483-6331
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Dr. Richard Edwin Lizak, D.C.
Title
Chiropractor
Phone
(601) 483-6330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 476 MA Primary

Addresses

Primary practice location

1900 23Rd Ave
Meridian, MS 39301-3107

Mailing address

1900 23Rd Ave
Meridian, MS 39301-3107
Phone (601) 483-6330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120607000623 MS Part B Supplier - Clinic/Group Practice 4981866621 Receives reassigned benefits from 2 practitioners
Practice locations: Meridian, MS

National Provider Directory

National Provider Directory

Locations

1900 23rd Ave
Meridian, MS 39301
Phone (601) 483-5901

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1194081380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 23RD AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393013107",
            "telephone_number": "601-483-6330",
            "fax_number": "601-483-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 23RD AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393013107",
            "telephone_number": "601-483-6330",
            "fax_number": "601-483-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E. LIZAK, D.C., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "LIZAK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "601-483-6330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.