Individual provider Active NPI

Bobby Joseph Luster, DC

  • Chiropractor
  • Wetumpka, AL
National Provider Identifier
1538249149
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2153 Issued in AL
Practice address
2412 US Highway 231
Wetumpka, AL 36093-1209
Phone
(334) 514-7327
Fax
(334) 514-7328
NPI assigned
Oct 17, 2006
Last updated
Aug 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2153 AL Primary

Addresses

Primary practice location

2412 US Highway 231
Wetumpka, AL 36093-1209

Mailing address

2412 US Highway 231
Wetumpka, AL 36093-1209
Phone (334) 514-7327

Other identifiers 2

IdentifierTypeStateIssuer
051549418OtherALBCBS
051532805OtherALBCBSAL

Other names 1

  • Dr. Joey Luster Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000738 AL Practitioner - Chiropractic 3476624834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2153ALMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Chiropractic, LLC Chiropractor CurrentSince May 22, 2008 Accepting new patients
Carl Edward Nelson Estate Chiropractor Past Accepting new patients

Locations

106 Court St
Wetumpka, AL 36092
Phone (334) 403-5789

2412 US Highway 231
Wetumpka, AL 36093
Phone (334) 514-7327

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, 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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1538249149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 US HIGHWAY 231",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360931209",
            "telephone_number": "334-514-7327",
            "fax_number": "334-514-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 US HIGHWAY 231",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360931209",
            "telephone_number": "334-514-7327",
            "fax_number": "334-514-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTER",
        "first_name": "BOBBY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051549418",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL",
            "identifier": "051532805",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOEY",
            "last_name": "LUSTER",
            "prefix": "DR.",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wetumpka, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.