Ryan Eddy Lutz, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3838 Issued in SC

Practice address

103 Sherman Dr
Boiling Springs, SC 29316-4879

Phone

(864) 420-5610

Fax

(866) 867-7043

NPI assigned

Jul 10, 2013

Last updated

Jul 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1275974073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SHERMAN DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293164879",
            "telephone_number": "864-420-5610",
            "fax_number": "866-867-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SHERMAN DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293164879",
            "telephone_number": "864-420-5610",
            "fax_number": "866-867-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "RYAN",
        "middle_name": "EDDY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3838",
            "primary": true
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "SC",
            "license": "3838",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "SC",
            "license": "3838",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "3838",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "SC",
            "license": "3838",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mary Black Health System, LLC (Foothills Family Medicine Boiling Springs)

• Chiropractor in Boiling Springs, SC
• Providers in Boiling Springs, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.