Samuel E Liscum, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1563 Issued in LA

Practice address

24012 Maplewood Dr
Suite 2
Sulphur, LA 70663

Phone

(337) 439-7007

Fax

(337) 439-7011

NPI assigned

Jul 13, 2006

Last updated

May 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Ortho Rehab, P.a.

  dba Human Performance: a Wellness & Rehab Center

  • Chiropractor
  • Lake Charles, LA
  • NPI 1679766711
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1396760096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7304 OLSEN RD",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706657796",
            "telephone_number": "337-439-7007",
            "fax_number": "337-439-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 MAPLEWOOD DR",
            "address_2": "SUITE 2",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "70663",
            "telephone_number": "337-439-7007",
            "fax_number": "337-439-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISCUM",
        "first_name": "SAMUEL",
        "middle_name": "E",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Michelle Leger, CNM
• Sasha Lejune, BCBA
• Eddie Earl Lewis III, PHARMD
• Lights on ABA Services, LLC
• Marie K Lionberger, PHARMD
• John Long, RPH
• Louisiana CVS Pharmacy, L.L.C. (CVS Pharmacy 05612)
• Louisiana Occupational Medicine and Safety Institute (Workforce Medical Center)
• Louisiana United Methodist Children & Family Services, Inc (Methodist Children's Home of Southwest Louisiana)
• Kristina Adele Lounsberry, PT

• Chiropractor in Sulphur, LA
• Providers in Sulphur, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.