Individual provider Active NPI

Gregory E Luke, D.C.

  • Chiropractor
  • Superior, WI
National Provider Identifier
1568503035
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3353 Issued in WI
Practice address
2121 E 5TH St
Superior, WI 54880-3610
Phone
(715) 398-6679
Fax
(715) 398-6080
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3353 WI Primary

Addresses

Primary practice location

2121 E 5TH St
Superior, WI 54880-3610

Mailing address

2121 E 5TH St
Superior, WI 54880-3610
Phone (715) 398-6679

Other identifiers 1

IdentifierTypeStateIssuer
38894700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3353WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Omnia Wellness and Recovery PastSince Oct 21, 2024 Accepting new patients
Lake Superior Chiropractic Office, S.C. Chiropractor PastSince Nov 20, 2018 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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1568503035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803610",
            "telephone_number": "715-398-6679",
            "fax_number": "715-398-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803610",
            "telephone_number": "715-398-6679",
            "fax_number": "715-398-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "GREGORY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38894700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.