Organization Active NPI

Keystone Chiropractic LLC

  • Chiropractor
  • Huntsville, AL
National Provider Identifier
1609172048
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2253 Issued in AL
Legal business name
KEYSTONE CHIROPRACTIC LLC
Practice address
3322 Memorial Pkwy SW
Suite 617
Huntsville, AL 35801-5335
Phone
(256) 270-9993
Fax
(256) 270-9994
NPI assigned
Feb 2, 2011
Last updated
Feb 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
Dr. Lisa D. Ingrum, D.C.
Title
Chiropractor
Phone
(256) 270-9993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2253 AL Primary

Addresses

Primary practice location

3322 Memorial Pkwy SW
Suite 617
Huntsville, AL 35801-5335

Mailing address

3322 Memorial Pkwy SW
Suite 617
Huntsville, AL 35801-5335
Phone (256) 270-9993

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000103 AL Part B Supplier - Clinic/Group Practice 5799965836 Receives reassigned benefits from 1 practitioner
Practice locations: Huntsville, AL

National Provider Directory

National Provider Directory

Locations

3322 Memorial Pkwy SW
Ste 617
Huntsville, AL 35801
Phone (256) 270-9993

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1609172048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 MEMORIAL PKWY SW",
            "address_2": "SUITE 617",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015335",
            "telephone_number": "256-270-9993",
            "fax_number": "256-270-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 MEMORIAL PKWY SW",
            "address_2": "SUITE 617",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015335",
            "telephone_number": "256-270-9993",
            "fax_number": "256-270-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "INGRUM",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "256-270-9993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.