Individual provider Active NPI

Lewis James Pagel, DC

  • Chiropractor
  • Kotzebue, AK
National Provider Identifier
1497851372
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
455 Issued in AK
Practice address
151 Second Ave
Kotzebue, AK 99752-0970
Phone
(907) 442-4435
Fax
(907) 442-4405
NPI assigned
Sep 16, 2006
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4682 MN
Chiropractor 111N00000X 455 AK Primary

Addresses

Primary practice location

151 Second Ave
Kotzebue, AK 99752-0970

Mailing address

PO Box 970
Kotzebue, AK 99752-0970
Phone (907) 412-1785

Other practice location 1

501 E Bremner St
Valdez, AK, AK 99686-1706
Phone (907) 412-1785

Other identifiers 2

IdentifierTypeStateIssuer
620142300MedicaidMN
88G23PAOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171009002617 AK Practitioner - Chiropractic 6406897628 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4682MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic Kotzebue, LLC Chiropractor CurrentSince Aug 31, 2017 Accepting new patients
Arctic Chiropractic Valdez LLC Chiropractor CurrentSince Dec 21, 2021 Accepting new patients
SG Chiropractic PC Chiropractor PastSince Mar 16, 2014 Accepting new patients
Advanced Body Chiropractic PA Chiropractor Past Accepting new patients

Locations

1150 S Colony Way
Ste 3226
Palmer, AK 99645

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1497851372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520970",
            "telephone_number": "907-412-1785",
            "fax_number": "907-442-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SECOND AVE",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520970",
            "telephone_number": "907-442-4435",
            "fax_number": "907-442-4405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 E Bremner St",
            "address_purpose": "LOCATION",
            "city": "Valdez, AK",
            "state": "AK",
            "postal_code": "996861706",
            "country_code": "US",
            "telephone_number": "907-412-1785",
            "fax_number": "907-835-8702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGEL",
        "first_name": "LEWIS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4682",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620142300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88G23PA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kotzebue, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.