Individual provider Active NPI

James Robert Lutz, DC

  • Chiropractor
  • West Bend, WI
National Provider Identifier
1790846673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1965012 Issued in WI
Practice address
2150 Chestnut Street
West Bend, WI 53095-2908
Phone
(262) 334-5431
Fax
(262) 335-6481
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1965012 WI Primary

Addresses

Primary practice location

2150 Chestnut Street
West Bend, WI 53095-2908

Mailing address

2150 Chestnut Street
West Bend, WI 53095-2908
Phone (262) 334-5431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071105000271 WI Practitioner - Chiropractic 9234226499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutz Chiropractic SCGroup PAC ID 2062509227, 3 clinicians

Practice addresses (Care Compare)

2150 Chestnut St
West Bend, WI 53095-2908
Phone (262) 334-5431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1965012WIMDChiropractor
1965WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutz Chiropractic SC Chiropractor CurrentSince Jan 1, 1966 Accepting new patients

Locations

2150 Chestnut St
West Bend, WI 53095
Phone (262) 334-5431

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790846673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 CHESTNUT STREET",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952908",
            "telephone_number": "262-334-5431",
            "fax_number": "262-335-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 CHESTNUT STREET",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952908",
            "telephone_number": "262-334-5431",
            "fax_number": "262-335-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1965012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.