Lake Chiropractic, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5818 Issued in CO

Legal business name

LAKE CHIROPRACTIC, PC

Practice address

40031 US Highway 160
Suite C
Bayfield, CO 81122-8746

Phone

(970) 884-1072

Fax

(970) 884-1074

NPI assigned

Feb 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrew E Lake, D.C.NPI 1902918519

Title

President

Phone

(970) 884-1072

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: drlake@lcp0005.direct.chirotouch.md

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Edgar Lake, D.C.

  • Chiropractor
  • Bayfield, CO
  • NPI 1902918519
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346385143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1745",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811221745",
            "telephone_number": "970-884-1072",
            "fax_number": "970-884-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40031 US HIGHWAY 160",
            "address_2": "SUITE C",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811228746",
            "telephone_number": "970-884-1072",
            "fax_number": "970-884-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-884-1072",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ryan Jimenez
• Jessica Keitz, LCSW
• Tony Patrick Kimball, DC
• Preston R Knight, D.D.S.
• La Plata County School District 10 JT-R
• Andrew Edgar Lake, D.C.
• Anne Lane, LPC
• Sarah Lynne Lewis, LMT
• Lifetime Eyecare PC
• Lirot Inc (Bayfield Pharmacy)

• Chiropractor in Bayfield, CO
• Providers in Bayfield, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.