Individual provider Active NPI

Lawrence Patrick Lawicki, DC

  • Chiropractor
  • Glen Allen, VA
National Provider Identifier
1427269273
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556535 Issued in VA
Practice address
201 Concourse Blvd
Suite 102
Glen Allen, VA 23059-5640
Phone
(804) 527-0092
Fax
(804) 527-0211
NPI assigned
May 24, 2007
Last updated
Dec 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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 0104556535 VA Primary

Addresses

Primary practice location

201 Concourse Blvd
Suite 102
Glen Allen, VA 23059-5640

Mailing address

201 Concourse Blvd
Suite 102
Glen Allen, VA 23059-5640
Phone (804) 527-0092

Other identifiers 1

IdentifierTypeStateIssuer
0104556535OtherVAVA STATE MEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000522 NJ Practitioner - Chiropractic 5193883403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

590 Hwy 35
Suite 1
Red Bank, NJ 07701-5067
Phone (732) 796-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104556535VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Spine & Disc Center,LLC Chiropractor CurrentSince Sep 27, 2010 Accepting new patients
Richmond Chiropractic Center, LLC Chiropractor Past Accepting new patients
Central Virginia Disc Center Chiropractor Past Accepting new patients
Be Your Best Chiropractic, LLC Chiropractor Past Accepting new patients

Locations

590 Highway 35
Ste 1
Red Bank, NJ 07701
Phone (732) 796-0333

Organizations & group practices 4

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1427269273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CONCOURSE BLVD",
            "address_2": "SUITE 102",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595640",
            "telephone_number": "804-527-0092",
            "fax_number": "804-527-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CONCOURSE BLVD",
            "address_2": "SUITE 102",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595640",
            "telephone_number": "804-527-0092",
            "fax_number": "804-527-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWICKI",
        "first_name": "LAWRENCE",
        "middle_name": "PATRICK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STATE MEDICAL LICENSE",
            "identifier": "0104556535",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

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