Lighthouse Chiropractic Health Center, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3331 Issued in MN

Legal business name

LIGHTHOUSE CHIROPRACTIC HEALTH CENTER, INC

Practice address

710 Dodge Ave NW
Suite C
Elk River, MN 55330-2019

Phone

(763) 441-1701

Fax

(763) 441-5348

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Martin O Eng, DCNPI 1740255686

Title

Owner

Phone

(763) 441-1701

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martin O Eng, D.C

  • Chiropractor
  • Elk River, MN
  • NPI 1740255686
  Medicare reassignment NPD Authorized official
• James Bradley Dietz, D.C.

  • Chiropractor
  • Saint Paul, MN
  • NPI 1881057651
  Medicare reassignment NPD
• Christopher James Slice

  • Chiropractor
  • Big Lake, MN
  • NPI 1548466113
  NPD (past)
• Isaac Caleb Hill, D.C.

  • Chiropractor
  • Danville, VA
  • NPI 1427307719
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1487721684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 DODGE AVE NW",
            "address_2": "SUITE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302019",
            "telephone_number": "763-441-1701",
            "fax_number": "763-441-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 DODGE AVE NW",
            "address_2": "SUITE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302019",
            "telephone_number": "763-441-1701",
            "fax_number": "763-441-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE CHIROPRACTIC HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "ENG",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-441-1701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C580ST",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6855253-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Lawrence, NP-C
• Cassidy Caitlin Lehrke
• Tessa Lorraine Lemke
• Michelle Lenertz
• Jill Marie Levin, MSW
• Kristin Lindberg, ATC
• Lori Linn-Orn, DDS
• Kayla Margaret Lippert
• Chase Liska
• Living Well Counseling, LLC

• Chiropractor in Elk River, MN
• Providers in Elk River, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.