Organization Active NPI

Lis Chiropractic Corp

  • Clinic/Center
  • Cupertino, CA
National Provider Identifier
1750806857
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIS CHIROPRACTIC CORP
Practice address
21613 Stevens Creek Blvd
Cupertino, CA 95014-1167
Phone
(408) 255-5018
Fax
(408) 255-2599
NPI assigned
Aug 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Dr. Ming Li, DCNPI 1659687044
Title
Owner/Doctor
Phone
(408) 255-5018

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 31741 CA
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X 16080 CA
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

21613 Stevens Creek Blvd
Cupertino, CA 95014-1167

Mailing address

21613 Stevens Creek Blvd
Cupertino, CA 95014-1167
Phone (408) 255-5018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221201002257 CA Part B Supplier - Clinic/Group Practice 6608244249 Receives reassigned benefits from 1 practitioner
Practice locations: Cupertino, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1750806857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21613 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950141167",
            "telephone_number": "408-255-5018",
            "fax_number": "699-333-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21613 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950141167",
            "telephone_number": "408-255-5018",
            "fax_number": "408-255-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIS CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "MING",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "408-255-5018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31741",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16080",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.