Lighthouse Chiropractic, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LIGHTHOUSE CHIROPRACTIC, PA

Practice address

10700 Highway 55
Suite 100
Plymouth, MN 55441-6100

Phone

(763) 543-9080

Fax

(763) 543-9082

NPI assigned

Jan 12, 2011

Last updated

Jan 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian Dale Boyd, DCNPI 1376608570

Title

President

Phone

(763) 543-9080

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 2

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.

• Brian Dale Boyd, DC

  • Chiropractor
  • Plymouth, MN
  • NPI 1376608570
  Medicare reassignment NPD Authorized official
• Paul Daeboo Moon, D.C.

  • Chiropractor
  • Plymouth, MN
  • NPI 1871663815
  NPD

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1427353093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 HIGHWAY 55",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416100",
            "telephone_number": "763-543-9080",
            "fax_number": "763-543-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 HIGHWAY 55",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416100",
            "telephone_number": "763-543-9080",
            "fax_number": "763-543-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-543-9080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Force-Cervella, Inc
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• Lifeforce Therapies
• Lifetime Wellness Center, P.a.
• Elissa Light, MS SLP CCC
• Christine Ann Lilienthal
• Lincare Inc
• Emily Lindenfelser, RD, LD
• Anne R Lindgren, CCC, SLP
• Colin L Lindgren

• Chiropractor in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.