Larry Lee Novotny, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1962 Issued in MN

Practice address

614 Hawthorne St
Alexandria, MN 56308-1661

Phone

(320) 762-2309

Fax

(320) 762-2300

NPI assigned

Nov 3, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Lake Region Family Chiropractic Clinic

  • Chiropractor
  • Alexandria, MN
  • NPI 1194804708
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295814879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 HAWTHORNE ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081661",
            "telephone_number": "320-762-2309",
            "fax_number": "320-762-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 HAWTHORNE ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081661",
            "telephone_number": "320-762-2309",
            "fax_number": "320-762-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "LARRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PIN #",
            "identifier": "44-48002",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4C812NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erick William Nolting, DDS
• Gina Lynn Nordsiden-Brown, D.O.
• Kacie Norlien, LICSW
• Northway Academy, Inc.
• Northwest Industrial Rehabilitation Services Inc.
• Nurture Women'S Therapy, LLC
• Andrea Nyberg, MA, OTR/L, CLT
• Hillary Renee O'Connor
• Oakdale Health Enterprises, Inc.
• Julie A Obrien

• All providers in Alexandria, MN
• Chiropractor in Minnesota

• 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.

Verify at the official NPI Registry.