Lisa K Kucma, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3401 Issued in NC

Practice address

4023 Village Park Dr
Knightdale, NC 27545-7044

Phone

(919) 261-9444

Fax

(919) 261-9470

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lisa K Hetrick-Kucma Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Camelot Chiropractic Centre, Inc.

  • Chiropractor
  • Knightdale, NC
  • NPI 1245391366
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1689792004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 VILLAGE PARK DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457044",
            "telephone_number": "919-261-9444",
            "fax_number": "919-261-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 VILLAGE PARK DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457044",
            "telephone_number": "919-261-9444",
            "fax_number": "919-261-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCMA",
        "first_name": "LISA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "085V8",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902485",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HETRICK-KUCMA",
            "middle_name": "K",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Knightdale Family Practice
• Christine Anne Kornegay, DPT
• Kristy Thomas
• Caroline Kruse
• Jason N Kucma, D.C.
• Odeta Kulenica
• Brianna Kurilla, LCMHC
• Laing Dermatology & Skin Cancer Center PA
• Valerie B Laing, MD
• Alixandra Megan Lakow, PT, DPT

• Chiropractor in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.