NPIMap

Organization Active NPI

Lana Surgenor Chiropractic, Inc.

Doing business as Soul Shine Family Chiropractic

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1417169533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
29395 Issued in CA
Legal business name
LANA SURGENOR CHIROPRACTIC, INC.
Doing business as
Soul Shine Family Chiropractic
Practice address
858 Second Street
Santa Rosa, CA 95404-4610
Phone
(707) 525-9950
Fax
(707) 525-9230
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lana Marie Surgenor, D.CNPI 1083649412
Title
Chiropractor
Phone
(707) 525-9950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 29395 CA Primary

Addresses

Primary practice location

858 Second Street
Santa Rosa, CA 95404-4610

Mailing address

858 Second Street
Santa Rosa, CA 95404-4610
Phone (707) 525-9950

Other names 1

  • Soul Shine Family Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417169533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "858 SECOND STREET",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044610",
            "telephone_number": "707-525-9950",
            "fax_number": "707-525-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "858 SECOND STREET",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044610",
            "telephone_number": "707-525-9950",
            "fax_number": "707-525-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANA SURGENOR CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SURGENOR",
        "authorized_official_first_name": "LANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "707-525-9950",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "29395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soul Shine Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.