Active NPI
Gerald Thomas Lalla, D.C.
- Chiropractor
- Shoreview, MN
National Provider Identifier
1770505745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1142
- Practice address
- 520 Highway 96 W
Suite 200
Shoreview, MN 55126-3202 - Phone
- (651) 484-8521
- Fax
- (651) 484-7374
- NPI assigned
- Jul 25, 2006
- 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 | 1142 | MN | Primary |
Addresses
Primary practice location
520 Highway 96 W
Suite 200
Shoreview, MN 55126-3202
Mailing address
520 Highway 96 W
Suite 200
Shoreview, MN 55126-3202
Phone (651) 484-8521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24793LA | Other | MN | BLUECROSS/BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1142 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Step Therapies, Inc. | Past | Accepting new patients |
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.
-
- Specialist
- Little Canada, MN
- NPI 1174728257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388966400000",
"number": "1770505745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 HIGHWAY 96 W",
"address_2": "SUITE 200",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551263202",
"telephone_number": "651-484-8521",
"fax_number": "651-484-7374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 HIGHWAY 96 W",
"address_2": "SUITE 200",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551263202",
"telephone_number": "651-484-8521",
"fax_number": "651-484-7374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALLA",
"first_name": "GERALD",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2014-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1142",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "24793LA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shoreview, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.