Lance William Neubauer – Chiropractor in Waconia, MN

Key facts

NPI: 1760906804
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 6384 (MN)
Practice address: 20 W Main St
Waconia, MN 55387-1020
Phone: (952) 442-9876
NPI assigned: Jul 31, 2017
Sex: Male
Sole proprietor: No

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.

Neubauer Chiropractic Health Center, PA Chiropractor · Chaska, MN · NPI 1376832485

NPD (past) CHIROPRACTOR
Neubauer Chiropractic Health Center, PA Chiropractor · Waconia, MN · NPI 1851323752

NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
6384	MN	MD	Physical Therapist

Practice roles

Organization	Specialty	Status	New patients
Neubauer Chiropractic Health Center, PA	Chiropractor	Past	Accepting new patients
Neubauer Chiropractic Health Center, PA	Chiropractor	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	6384	MN	Yes

Addresses

Primary practice location

20 W Main St
Waconia, MN 55387-1020

Mailing address

20 W Main St
Waconia, MN 55387-1020

Other identifiers

Identifier	Type	State	Issuer
6384	Other	MN	MINNESOTA CHIROPRACTIC LICENSE NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 31, 2017.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1760906804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W MAIN ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W MAIN ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871020",
            "telephone_number": "952-442-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBAUER",
        "first_name": "LANCE",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA CHIROPRACTIC LICENSE NUMBER",
            "identifier": "6384",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

All providers in Waconia, MN · Chiropractor in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.