Organization Active NPI

Lake View Family Chiropractic Clinic, PC

  • Chiropractor
  • Lake View, IA
National Provider Identifier
1649500174
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A06123 Issued in IA
Legal business name
LAKE VIEW FAMILY CHIROPRACTIC CLINIC, PC
Practice address
517 3Rd St
Lake View, IA 51450-7605
Phone
(712) 657-2225
NPI assigned
Jan 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Authorized official

Name
Dr. Julie ClaytonNPI 1427021336
Title
Owner
Phone
(712) 657-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X A06123 IA Primary

Addresses

Primary practice location

517 3Rd St
Lake View, IA 51450-7605

Mailing address

517 3Rd St
Lake View, IA 51450-7605
Phone (712) 657-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100414000078 IA Part B Supplier - Clinic/Group Practice 9032245501 Receives reassigned benefits from 1 practitioner
Practice locations: Lake View, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1649500174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 3RD ST",
            "city": "LAKE VIEW",
            "state": "IA",
            "postal_code": "514507605",
            "telephone_number": "712-657-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 3RD ST",
            "city": "LAKE VIEW",
            "state": "IA",
            "postal_code": "514507605",
            "telephone_number": "712-657-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VIEW FAMILY CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-657-2225",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake View, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.