Individual provider Active NPI

Lynn M Randall, DC

  • Chiropractor
  • Dubuque, IA
National Provider Identifier
1316058506
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A06225 Issued in IA
Practice address
3375 Lake Ridge Dr
Dubuque, IA 52003-7864
Phone
(563) 207-8932
Fax
(563) 207-8935
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3764012 WI
Chiropractor 111N00000X A06225 IA Primary

Addresses

Primary practice location

3375 Lake Ridge Dr
Dubuque, IA 52003-7864

Mailing address

3375 Lake Ridge Dr
Dubuque, IA 52003-7864
Phone (563) 207-8932

Other identifiers 2

IdentifierTypeStateIssuer
12828OtherWIDEAN HEALTH PLAN
38932000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211119001722 IA Practitioner - Chiropractic 9739140047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3430 Dodge St
Unit 25
Dubuque, IA 52003-5218
Phone (563) 581-1503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A06225IAMDChiropractor
3764012WIMDChiropractor
3764WIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Randall Chiropractic and Wellness, LLC Chiropractor CurrentSince Jul 9, 2025 Accepting new patients
Statera LLC CurrentSince Nov 18, 2021 Accepting new patients
Lettman Chiropractic Rehab Care Chiropractor Past Accepting new patients
Chiropractic Rehab Center, PC Chiropractor Past Accepting new patients

Locations

3375 Lake Ridge Dr
Dubuque, IA 52003
Phone (563) 207-8932

3375 Lake Ridge Dr
#H
Dubuque, IA 52003
Phone (563) 207-8932

3430 Dodge St
Unit 25
Dubuque, IA 52003
Phone (563) 581-1503

1082 Cedar Cross Rd
Ste 1002
Dubuque, IA 52003
Phone (563) 581-1503

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1316058506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 LAKE RIDGE DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037864",
            "telephone_number": "563-207-8932",
            "fax_number": "563-207-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 LAKE RIDGE DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037864",
            "telephone_number": "563-207-8932",
            "fax_number": "563-207-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3764012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "12828",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38932000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.