Individual provider Active NPI

Jason Troy Lundgren, DC

  • Chiropractor
  • Chandler, AZ
National Provider Identifier
1841318474
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5485 Issued in AZ
Practice address
805 E Warner Rd Ste 102
Chandler, AZ 85225-1000
Phone
(480) 732-0442
Fax
(480) 732-9868
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5485 AZ Primary

Addresses

Primary practice location

805 E Warner Rd Ste 102
Chandler, AZ 85225-1000

Mailing address

805 E Warner Rd Ste 102
Chandler, AZ 85225-1000
Phone (480) 732-0442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000671 AZ Practitioner - Chiropractic 8325006281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lundgren Chiropractic, P.C.Group PAC ID 8022037514, 2 clinicians

Practice addresses (Care Compare)

805 E Warner Rd
Suite 102
Chandler, AZ 85225-1000
Phone (480) 732-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5485AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lundgren Chiropractic, P.C. Chiropractor CurrentSince Aug 1, 2005 Accepting new patients
Grand Canyon Anesthesia LLC Past Accepting new patients

Locations

805 E Warner Rd
Ste 102
Chandler, AZ 85225
Phone (480) 732-0042

Organizations & group practices 2

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1841318474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E WARNER RD STE 102",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251000",
            "telephone_number": "480-732-0442",
            "fax_number": "480-732-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E WARNER RD STE 102",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852251000",
            "telephone_number": "480-732-0442",
            "fax_number": "480-732-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "JASON",
        "middle_name": "TROY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.