Individual provider Active NPI

Lucas Joe Ballenger, D.C.

  • Chiropractor
  • West Des Moines, IA
National Provider Identifier
1366766313
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007278 Issued in IA
Practice address
1121 Jordan Creek Pkwy Ste 100
West Des Moines, IA 50266-5816
Phone
(515) 271-5000
Fax
(515) 271-5006
NPI assigned
Mar 19, 2010
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 007278 IA
Sports Physician Chiropractor 111NS0005X 007278 IA
Chiropractor 111N00000X 007278 IA Primary

Addresses

Primary practice location

1121 Jordan Creek Pkwy Ste 100
West Des Moines, IA 50266-5816

Mailing address

1121 Jordan Creek Pkwy Ste 100
West Des Moines, IA 50266-5816
Phone (515) 271-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000387 IA Practitioner - Chiropractic 0941331441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ballenger Chiropractic and Acupuncture, PLLCGroup PAC ID 4789715277, 3 clinicians

Practice addresses (Care Compare)

1121 Jordan Creek Pkwy
Suite 100
West Des Moines, IA 50266-5993
Phone (515) 271-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ballenger Chiropractic & Acupuncture, PLLC CurrentSince May 10, 2010 Accepting new patients

Locations

1121 Jordan Creek Pkwy
West Des Moines, IA 50266
Phone (515) 271-5000

1121 Jordan Creek Pkwy
Ste 100
West Des Moines, IA 50266
Phone (319) 239-2343

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": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1366766313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 JORDAN CREEK PKWY STE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665816",
            "telephone_number": "515-271-5000",
            "fax_number": "515-271-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 JORDAN CREEK PKWY STE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665816",
            "telephone_number": "515-271-5000",
            "fax_number": "515-271-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENGER",
        "first_name": "LUCAS",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-19",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "IA",
            "license": "007278",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IA",
            "license": "007278",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.