Active NPI
Lori R. Enevoldsen, D.C.
- Chiropractor
- Dyer, IN
National Provider Identifier
1225041122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08001851A
- Practice address
- 1100 Joliet St Ste 104
Dyer, IN 46311-1995 - Phone
- (219) 865-9917
- Fax
- (219) 865-9957
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001851A | IN | Primary |
Addresses
Primary practice location
1100 Joliet St Ste 104
Dyer, IN 46311-1995
Mailing address
1100 Joliet St Ste 104
Dyer, IN 46311-1995
Phone (219) 865-9917
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
| License | State | Type | Specialty |
|---|---|---|---|
| 08001851A | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225041122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 JOLIET ST STE 104",
"city": "DYER",
"state": "IN",
"postal_code": "463111995",
"telephone_number": "219-865-9917",
"fax_number": "219-865-9957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 JOLIET ST STE 104",
"city": "DYER",
"state": "IN",
"postal_code": "463111995",
"telephone_number": "219-865-9917",
"fax_number": "219-865-9957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENEVOLDSEN",
"first_name": "LORI",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08001851A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dyer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.