Individual provider Active NPI

David R Lee, DC

  • Chiropractor
  • Champlin, MN
National Provider Identifier
1629164462
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3733 Issued in MN
Practice address
11350 Aquila Dr N Ste 825
Champlin, MN 55316-3798
Phone
(763) 323-3456
Fax
(763) 323-9922
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 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 3733 MN Primary

Addresses

Primary practice location

11350 Aquila Dr N Ste 825
Champlin, MN 55316-3798

Mailing address

11350 Aquila Dr N Ste 825
Champlin, MN 55316-3798
Phone (763) 323-3456

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110707000636 MN Practitioner - Chiropractic 6507044997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11650 Winnetka Ave N
Champlin, MN 55316-2700
Phone (763) 323-3456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3733MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Health Clinic of Chiropractic Chiropractor CurrentSince Mar 15, 2001 Accepting new patients

Locations

11650 Winnetka Ave N
Champlin, MN 55316
Phone (763) 323-3456

11350 Aquila Dr N
Ste 825
Champlin, MN 55316
Phone (763) 323-3456

Organizations & group practices 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1629164462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 AQUILA DR N STE 825",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163798",
            "telephone_number": "763-323-3456",
            "fax_number": "763-323-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 AQUILA DR N STE 825",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163798",
            "telephone_number": "763-323-3456",
            "fax_number": "763-323-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.