Lance Gary Brisky, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5709 Issued in MN

Practice address

4397 Malmo Cir
Eagan, MN 55123-1737

Phone

(651) 485-9214

Fax

(651) 730-9210

NPI assigned

Dec 5, 2012

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 WI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blau Chiropractic SCGroup PAC ID 2769498104, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Blau Chiropractic SC

  • Chiropractor
  • Portage, WI
  • NPI 1003003716
  Medicare reassignment Care Compare group NPD
• Drews Family Chiropractic Inc.

  • Chiropractor
  • Woodbury, MN
  • NPI 1003070731
  NPD (past)

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1477898286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4397 MALMO CIR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231737",
            "telephone_number": "651-485-9214",
            "fax_number": "651-730-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4397 MALMO CIR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231737",
            "telephone_number": "651-485-9214",
            "fax_number": "651-730-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISKY",
        "first_name": "LANCE",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridge Centers LLC
• Bright Spectrum Center
• Logan Brinn, PHARMD
• Jamie Briski
• Karen Brisky
• Kenneth Britton, D.O.
• Tara L Broadwater, MD
• Laura Evavold Broder, M.D.
• Michael Lee Broeker, MD
• Colette R Brogan, OT

• All providers in Eagan, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.