Organization Active NPI

Havelock Chiropractic Center PC

  • Chiropractor
  • Lincoln, NE
National Provider Identifier
1790721272
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
842 Issued in NE
Legal business name
HAVELOCK CHIROPRACTIC CENTER PC
Practice address
6132 Havelock Avenue
Suite a
Lincoln, NE 68507
Phone
(402) 467-5143
Fax
(402) 467-5145
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Authorized official

Name
David Walter Lauer, DCNPI 1215971122
Title
President Owner
Phone
(402) 467-5143

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 842 NE Primary

Addresses

Primary practice location

6132 Havelock Avenue
Suite a
Lincoln, NE 68507

Mailing address

6132 Havelock Avenue
Suite a
Lincoln, NE 68507
Phone (402) 467-5143

Other identifiers 4

IdentifierTypeStateIssuer
09675OtherNEBLUE CROSS BLUE SHIELD
27361OtherBLUE CROSS BLUE SHIELD (IDEUS)
4114OtherNEMIDLAND'S CHOICE
10025110600MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728000454 NE Part B Supplier - Clinic/Group Practice 4385614312 Receives reassigned benefits from 2 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory

Locations

6132 Havelock Ave
Ste A
Lincoln, NE 68507
Phone (402) 467-5143

6132 Havelock Ave
Lincoln, NE 68507
Phone (402) 467-5143

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1790721272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6132 HAVELOCK AVENUE",
            "address_2": "SUITE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68507",
            "telephone_number": "402-467-5143",
            "fax_number": "402-467-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6132 HAVELOCK AVENUE",
            "address_2": "SUITE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68507",
            "telephone_number": "402-467-5143",
            "fax_number": "402-467-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVELOCK CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "LAUER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "402-467-5143",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09675",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD (IDEUS)",
            "identifier": "27361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "4114",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025110600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.