Back Home Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BACK HOME CHIROPRACTIC LLC

Practice address

106 W Old Mill Rd
Fair Grove, MO 65648-8646

Phone

(417) 567-2001

NPI assigned

Oct 30, 2020

Last updated

Oct 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Lentz, DCNPI 1184224495

Title

Owner

Phone

(417) 844-4421

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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.

• Michael Lentz, DC, DACNB

  • Chiropractor
  • Fair Grove, MO
  • NPI 1184224495
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1639779473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 434",
            "city": "FAIR GROVE",
            "state": "MO",
            "postal_code": "656480434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W OLD MILL RD",
            "city": "FAIR GROVE",
            "state": "MO",
            "postal_code": "656488646",
            "telephone_number": "417-567-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK HOME CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "LENTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-844-4421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathy L. Brite, COTA/L
• Fair Grove R-X
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• Shawna Sue Gulick, MSW, LCSW
• Heartland LLC

• Chiropractor in Fair Grove, MO
• Providers in Fair Grove, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.