Individual provider Active NPI

Lisa Ann Fitzwilliams, D.C., C.N.

  • Nutrition Chiropractor
  • Carbondale, CO
National Provider Identifier
1679776009
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
0006444 Issued in CO
Practice address
326 Highway 133
Suite 270a
Carbondale, CO 81623-2507
Phone
(970) 987-4470
Fax
(970) 797-1493
NPI assigned
Jun 5, 2007
Last updated
Mar 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 0006444 CO Primary

Addresses

Primary practice location

326 Highway 133
Suite 270a
Carbondale, CO 81623-2507

Mailing address

326 Highway 133
Suite 270a
Carbondale, CO 81623-2507
Phone (970) 987-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0006444COMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kettle Moraine Health Center, S.C. PastSince Apr 30, 2003 Accepting new patients
Beane Chiropractic Past Accepting new patients
Arctic Chiropractic Sitka LLC PastSince Jun 25, 2017 Accepting new patients

Organizations & group practices 3

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1679776009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 HIGHWAY 133",
            "address_2": "SUITE 270A",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816232507",
            "telephone_number": "970-987-4470",
            "fax_number": "970-797-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 HIGHWAY 133",
            "address_2": "SUITE 270A",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816232507",
            "telephone_number": "970-987-4470",
            "fax_number": "970-797-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWILLIAMS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C., C.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CO",
            "license": "0006444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.