Lance Shane Ingwersen, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1181 Issued in ID

Practice address

104 S Daisy St
Suite a
Salmon, ID 83467-4333

Phone

(208) 756-5000

NPI assigned

Jul 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Salmon River Chiropractic IncGroup PAC ID 5092718536, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Salmon River Chiropractic Inc.

  • Chiropractor
  • Salmon, ID
  • NPI 1225068059
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295766822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S DAISY ST",
            "address_2": "SUITE A",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674333",
            "telephone_number": "208-756-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S DAISY ST",
            "address_2": "SUITE A",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674333",
            "telephone_number": "208-756-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGWERSEN",
        "first_name": "LANCE",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Human Dynamics and Diagnostics, LLC
• Jill E Hunt
• Marla Hunteman
• Idaho Dept of Health & Welfare Region 7 CMH Clinic Salmon
• Idaho Dept of Health & Welfare Region 7 CMH PSR Salmon
• Dustin J Jones, OD
• Jaycelin Jones, M.S. SLP
• Joseph L. Rodriguez DDS and Associates PLLC
• Lauren Juliano
• Nancy Kern, LMT, MLD-C

• Chiropractor in Salmon, ID
• Providers in Salmon, ID by specialty
• Chiropractor in Idaho

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.