Individual provider Active NPI

Lee Schwartz, D.C.

  • Chiropractor
  • White Bear Lake, MN
National Provider Identifier
1306992011
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3712 Issued in MN
Practice address
4801 Highway 61 N Ste 105
White Bear Lake, MN 55110-2748
Phone
(651) 762-5433
Fax
(651) 762-7504
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3712 MN Primary

Addresses

Primary practice location

4801 Highway 61 N Ste 105
White Bear Lake, MN 55110-2748

Mailing address

3494 Savannah Ave
White Bear Lake, MN 55110-4579
Phone (651) 779-2291

Other identifiers 2

IdentifierTypeStateIssuer
25156795OtherMNWAUSAU BENEFITS #
52D99SCOtherMNBCBS PROVIDER NUMBER

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
Healthsource of White Bear Lake, PLLC Chiropractor PastSince Jan 25, 2018 Accepting new patients
Burtis Chiropractic Center PA Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306992011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3494 SAVANNAH AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104579",
            "telephone_number": "651-779-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 HIGHWAY 61 N STE 105",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551102748",
            "telephone_number": "651-762-5433",
            "fax_number": "651-762-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAUSAU BENEFITS #",
            "identifier": "25156795",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "52D99SC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

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.

Verify at the official NPI Registry.