Individual provider Active NPI

Lance Fields Jeppesen, DC

  • Chiropractor
  • San Marcos, CA
National Provider Identifier
1750439451
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC17616 Issued in CA
Practice address
1146 San Marino Dr
San Marcos, CA 92078-4649
Phone
(760) 471-2033
Fax
(760) 471-2083
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC17616 CA Primary

Addresses

Primary practice location

1146 San Marino Dr
San Marcos, CA 92078-4649

Mailing address

1146 San Marino Dr
San Marcos, CA 92078-4649
Phone (760) 417-1477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120314000787 CA Practitioner - Chiropractic 0345409140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Medical Center, Inc.Group PAC ID 2567621352, 3 clinicians

Practice addresses (Care Compare)

1146 San Marino Dr
San Marcos, CA 92078-4649
Phone (760) 471-2033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC17616CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Medical Center, Inc. Chiropractor CurrentSince Dec 17, 2011 Accepting new patients
Scripps Health Current Accepting new patients

Locations

1146 San Marino Dr
San Marcos, CA 92078
Phone (760) 420-8848

1146 San Marino Dr
Ste L
San Marcos, CA 92078

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ljeppesen81153@scrippshlth.medalliesdirect.net

Organizations & group practices 2

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1750439451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 SAN MARINO DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784649",
            "telephone_number": "760-417-1477",
            "fax_number": "760-471-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 SAN MARINO DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784649",
            "telephone_number": "760-471-2033",
            "fax_number": "760-471-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPESEN",
        "first_name": "LANCE",
        "middle_name": "FIELDS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC17616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.