Individual provider Active NPI

Lori Danielle Kintzel, DC

  • Chiropractor
  • Freeport, IL
National Provider Identifier
1497861132
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012012 Issued in IL
Practice address
888 W Galena Ave
Freeport, IL 61032-3974
Phone
(815) 616-8424
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009222 MI
Chiropractor 111N00000X 038012012 IL Primary
Chiropractor 111N00000X 007392 IA

Addresses

Primary practice location

888 W Galena Ave
Freeport, IL 61032-3974

Mailing address

888 W Galena Ave
Freeport, IL 61032-3974
Phone (815) 616-8424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000112 IL Practitioner - Chiropractic 3375540289 Practice locations: Freeport, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

888 W Galena Ave
Freeport, IL 61032-3974
Phone (815) 616-8424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007392IAMDChiropractor
038012012ILMDChiropractor
2301009222MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Okemos Chiropractic Health Clinic, P.C. Chiropractor PastSince Mar 1, 2016 Accepting new patients
Big Vision, LLC Chiropractor PastSince Jul 22, 2004 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1497861132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W GALENA AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323974",
            "telephone_number": "815-616-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W GALENA AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323974",
            "telephone_number": "815-616-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINTZEL",
        "first_name": "LORI",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009222",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012012",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.