Individual provider Active NPI

Londyn Caroll Witmer, DC

  • Chiropractor
  • Lakeville, MN
National Provider Identifier
1750104535
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7275 Issued in MN
Practice address
17830 Kenwood TRL
Lakeville, MN 55044-9492
Phone
(952) 935-3345
Fax
(952) 435-8895
NPI assigned
Nov 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7275 MN Primary

Addresses

Primary practice location

17830 Kenwood TRL
Lakeville, MN 55044-9492

Mailing address

17830 Kenwood TRL
Lakeville, MN 55044-9492
Phone (952) 435-3345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111000797 MN Practitioner - Chiropractic 0547794794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exuberance Chiropractic and Wellness CenterGroup PAC ID 9234360454, 2 clinicians

Practice addresses (Care Compare)

17787 Kenwood TRL
Lakeville, MN 55044-9493
Phone (952) 435-3345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7275MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Exuberance Chiropractic & Wellness Center Chiropractor CurrentSince Nov 1, 2024 Accepting new patients

Locations

17830 Kenwood Trl
Lakeville, MN 55044
Phone (952) 435-3345

17787 Kenwood Trl
Lakeville, MN 55044
Phone (952) 435-3345

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1750104535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17830 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449492",
            "telephone_number": "952-435-3345",
            "fax_number": "952-435-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17830 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449492",
            "telephone_number": "952-935-3345",
            "fax_number": "952-435-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMER",
        "first_name": "LONDYN",
        "middle_name": "CAROLL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.

Verify at the official NPI Registry.