Individual provider Active NPI

David Robert Lutz, D.C.

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1245276302
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4667 Issued in KY
Practice address
3326 SW 4TH Place
Cape Coral, FL 33914
Phone
(502) 386-9385
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH12511 FL
Chiropractor 111N00000X 4667 KY Primary

Addresses

Primary practice location

3326 SW 4TH Place
Cape Coral, FL 33914

Mailing address

3026 SW 4TH PL
Cape Coral, FL 33914-4595
Phone (502) 386-9385

Other identifiers 5

IdentifierTypeStateIssuer
2735025000OtherKYPASSPORT ADVANTAGE
50011059OtherKYPASSPORT
85002319MedicaidKY
9989010OtherKYCIGNA PAL
P00428704OtherKYPALMETTO RAILROAD MEDICARE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shepherdsville Chiropractic and Rehab LLC Chiropractor PastSince Jul 1, 2016 Accepting new patients
D.R. Thomas V. Jacques D.C., PSC Chiropractor PastSince Dec 30, 2019 Accepting new patients
Lutz Health and Wellness LLC Chiropractor Past Accepting new patients
Shepherdsville Chiropractic, LLC Chiropractor PastSince Jun 26, 2006 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1245276302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 SW 4TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144595",
            "telephone_number": "502-386-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 SW 4TH PLACE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33914",
            "telephone_number": "502-386-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12511",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2735025000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50011059",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002319",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL",
            "identifier": "9989010",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RAILROAD MEDICARE",
            "identifier": "P00428704",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.