Individual provider Active NPI

Amanda Lea Lukes, D.C.

  • Chiropractor
  • Bemidji, MN
National Provider Identifier
1770928921
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5793 Issued in MN
Practice address
3620 Bemidji Ave N
Bemidji, MN 56601-4487
Phone
(218) 751-5145
Fax
(218) 444-2480
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5793 MN Primary

Addresses

Primary practice location

3620 Bemidji Ave N
Bemidji, MN 56601-4487

Mailing address

3620 Bemidji Ave N
Bemidji, MN 56601-4487
Phone (218) 751-5145

Other names 1

  • Amanda Lea Johnson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130531000071 MN Practitioner - Chiropractic 2860630936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Lukes Chiropractic and Wellness PLLCGroup PAC ID 9436430006, 2 clinicians

Practice addresses (Care Compare)

3620 Bemidji Ave N
Bemidji, MN 56601-4333
Phone (218) 751-4936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lukes Chiropractic and Wellness, P.L.L.C. Chiropractor CurrentSince Jan 1, 2017 Accepting new patients

Locations

3620 Bemidji Ave N
Bemidji, MN 56601
Phone (218) 751-4936

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": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1770928921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 BEMIDJI AVE N",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014487",
            "telephone_number": "218-751-5145",
            "fax_number": "218-444-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 BEMIDJI AVE N",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014487",
            "telephone_number": "218-751-5145",
            "fax_number": "218-444-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKES",
        "first_name": "AMANDA",
        "middle_name": "LEA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "JOHNSON",
            "middle_name": "LEA",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.