Organization Active NPI

Lubovich Chiropractic, P.a.

  • Chiropractor
  • Lakeville, MN
National Provider Identifier
1831211473
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2726 Issued in MN
Legal business name
LUBOVICH CHIROPRACTIC, P.A.
Practice address
10880 175TH CT W Ste 120
Lakeville, MN 55044-7493
Phone
(952) 898-4900
Fax
(952) 898-7626
NPI assigned
Apr 4, 2007
Last updated
May 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Authorized official

Name
Dr. Robert Clarence Lubovich, D.C.NPI 1528124005
Title
Owner
Phone
(952) 898-4900

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
Chiropractor 111N00000X 2726 MN Primary

Addresses

Primary practice location

10880 175TH CT W Ste 120
Lakeville, MN 55044-7493

Mailing address

10880 175TH CT W Ste 120
Lakeville, MN 55044-7493
Phone (952) 898-4900

Other identifiers 1

IdentifierTypeStateIssuer
0H011-LUOtherMNBLUE CROSS BLUE SHEILD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040112000031 MN Part B Supplier - Clinic/Group Practice 3779483318 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Lakeville, MN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

730 Main St
Ste 4
Elko New Market, MN 55054
Phone (952) 461-5110

10880 175th Ct W
Ste 120
Lakeville, MN 55044
Phone (952) 892-0898

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1831211473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10880 175TH CT W STE 120",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447493",
            "telephone_number": "952-898-4900",
            "fax_number": "952-898-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10880 175TH CT W STE 120",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447493",
            "telephone_number": "952-898-4900",
            "fax_number": "952-898-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBOVICH CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "LUBOVICH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-898-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "0H011-LU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.