Lakes Family Chiropractic Clinic P.a.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

3324 Issued in MN

Legal business name

LAKES FAMILY CHIROPRACTIC CLINIC P.A.

Practice address

7771 Lake Dr
Lino Lakes, MN 55014-1100

Phone

(651) 784-2225

Fax

(651) 784-2070

NPI assigned

Apr 14, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Brian Richard Carpenter, D.C.NPI 1326169772

Title

Chiropractor

Phone

(651) 784-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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.

• Brian Richard Carpenter

  • Chiropractor
  • Lino Lakes, MN
  • NPI 1326169772
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1659514198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7771 LAKE DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141100",
            "telephone_number": "651-784-2225",
            "fax_number": "651-784-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7771 LAKE DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141100",
            "telephone_number": "651-784-2225",
            "fax_number": "651-784-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES FAMILY CHIROPRACTIC CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "651-784-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": "3324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1326169772",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellie Kershisnik, MD
• Key Medical Supply, Inc.
• Sharon Lorraine King, RN
• Kaylee Jean Koski, DDS
• Susan Elizabeth Kreiner, PT
• Stephanie Lasch, LCMT
• Douglas J Latuseck, PSYD, LP
• Payton Christine Le, LMFT
• Pamela Lynn Lenz, CCC-SLP
• Rachael Lick

• Medical Specialty Clinic/Center in Lino Lakes, MN
• Providers in Lino Lakes, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; 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.