Active NPI
Chad Richard, D.C.
- Chiropractor
- Lake Charles, LA
National Provider Identifier
1720174170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 954
- Practice address
- Moss Bluff Chiropractic Clinic 119 Tahoe Dr
Lake Charles, LA 70611-5109 - Phone
- (337) 855-6306
- Fax
- (337) 855-7012
- NPI assigned
- Oct 5, 2006
- Last updated
- Mar 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 954 | LA | Primary |
Addresses
Primary practice location
Moss Bluff Chiropractic Clinic 119 Tahoe Dr
Lake Charles, LA 70611-5109
Mailing address
119 Tahoe Dr
PO Box 12571
Lake Charles, LA 70611-5109
Phone (337) 855-6306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
119 Tahoe Dr
Lake Charles, LA 70611-5109
Phone (337) 855-6306
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 954 | LA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moss Bluff Chiropractic Clinic | Chiropractor | Current | Accepting new patients |
Locations
119 Tahoe Dr
Moss Bluff, LA 70611
Phone (337) 855-6306
Organizations & group practices 1
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.
-
- Chiropractor
- Lake Charles, LA
- NPI 1659569119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1720174170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 TAHOE DR",
"address_2": "PO BOX 12571",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706115109",
"telephone_number": "337-855-6306",
"fax_number": "337-855-7012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MOSS BLUFF CHIROPRACTIC CLINIC 119 TAHOE DR",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706115109",
"telephone_number": "337-855-6306",
"fax_number": "337-855-7012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARD",
"first_name": "CHAD",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "LA",
"license": "954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.