Individual provider Active NPI

Beth Ann Lancaster, DC

  • Chiropractor
  • Pueblo, CO
National Provider Identifier
1376598862
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5271 Issued in CO
Practice address
4736 Eagleridge Cir
Pueblo, CO 81008-2120
Phone
(719) 404-1489
Fax
(719) 545-0642
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5271 CO Primary

Addresses

Primary practice location

4736 Eagleridge Cir
Pueblo, CO 81008-2120

Mailing address

4736 Eagleridge Cir
Pueblo, CO 81008-2120
Phone (719) 404-1489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000215 CO Practitioner - Chiropractic 2567439961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4736 Eagleridge Cir
Pueblo, CO 81008-2344
Phone (719) 404-1489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5271COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Chiropractic LLC Chiropractor CurrentSince Mar 13, 2008 Accepting new patients
Dr David W Pool PC Past Accepting new patients

Locations

2403 Santa Fe Dr
Ste 7
Pueblo, CO 81006
Phone (719) 404-1489

4736 Eagleridge Cir
Pueblo, CO 81008
Phone (719) 404-1489

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1376598862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 EAGLERIDGE CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082120",
            "telephone_number": "719-404-1489",
            "fax_number": "719-545-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 EAGLERIDGE CIR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082120",
            "telephone_number": "719-404-1489",
            "fax_number": "719-545-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.