Individual provider Active NPI

Richard A Lezotte, D.C.

  • Chiropractor
  • Dewitt, MI
National Provider Identifier
1346225687
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008037 Issued in MI
Practice address
1120 Commerce Park Dr
Suite D
Dewitt, MI 48820-7967
Phone
(517) 668-1300
Fax
(517) 669-7227
NPI assigned
Dec 9, 2005
Last updated
Jul 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008037 MI Primary

Addresses

Primary practice location

1120 Commerce Park Dr
Suite D
Dewitt, MI 48820-7967

Mailing address

1120 Commerce Park Dr
Suite D
Dewitt, MI 48820-7967
Phone (517) 668-1300

Other identifiers 2

IdentifierTypeStateIssuer
4400042OtherMIPHP
950A950100OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000843 MI Practitioner - Chiropractic 2163610007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard Lezotte DC. PC.Group PAC ID 8729049044, 2 clinicians

Practice addresses (Care Compare)

2843 E Grand River Ave
Suite 170
East Lansing, MI 48823-6723
Phone (517) 337-7463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008037MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Health Spine & Sport, P.C. Chiropractor CurrentSince Sep 20, 2010 Accepting new patients

Locations

2843 E Grand River Ave
Ste 170
East Lansing, MI 48823
Phone (517) 327-5200

Organizations & group practices 1

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1346225687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 COMMERCE PARK DR",
            "address_2": "SUITE D",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207967",
            "telephone_number": "517-668-1300",
            "fax_number": "517-669-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 COMMERCE PARK DR",
            "address_2": "SUITE D",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207967",
            "telephone_number": "517-668-1300",
            "fax_number": "517-669-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZOTTE",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "4400042",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950A950100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dewitt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.