Individual provider Active NPI

Phillip Jon Lueking, D.C.

  • Chiropractor
  • Holdrege, NE
National Provider Identifier
1316178981
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1579 Issued in NE
Practice address
1113 Burlington St
Holdrege, NE 68949-1706
Phone
(308) 995-2300
Fax
(308) 995-3979
NPI assigned
Jul 30, 2009
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1579 NE Primary

Addresses

Primary practice location

1113 Burlington St
Holdrege, NE 68949-1706

Mailing address

1113 Burlington St
Holdrege, NE 68949-1706
Phone (308) 995-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100111000119 NE Practitioner - Chiropractic 8729129903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1579NEMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wolf Chiropractic Clinic P.C. Chiropractor PastSince Jul 1, 1996 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1316178981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 BURLINGTON ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491706",
            "telephone_number": "308-995-2300",
            "fax_number": "308-995-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 BURLINGTON ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491706",
            "telephone_number": "308-995-2300",
            "fax_number": "308-995-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEKING",
        "first_name": "PHILLIP",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holdrege, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.