Individual provider Active NPI

Lucas Emmerich, DC

  • Chiropractor
  • Lakeville, MN
National Provider Identifier
1841881307
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6143-12 Issued in WI
Practice address
16301 Kenrick Ave
Lakeville, MN 55044-8494
Phone
(952) 595-6337
Fax
(952) 595-6336
NPI assigned
Jan 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6798 MN
Chiropractor 111N00000X 6143-12 WI Primary

Addresses

Primary practice location

16301 Kenrick Ave
Lakeville, MN 55044-8494

Mailing address

1451 Bluestem Blvd Ste C
Altoona, WI 54720-2619
Phone (715) 304-3683

Other practice location 1

1451 Bluestem Blvd Ste C
Altoona, WI 54720-2619
Phone (715) 304-3683

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419002272 WI Practitioner - Chiropractic 5991110728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1451 Bluestem Blvd
Suite C
Altoona, WI 54720-2619
Phone (715) 304-3683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6143-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Central Health LLC Chiropractor CurrentSince Mar 11, 2024 Accepting new patients

Locations

1451 Bluestem Blvd
Ste C
Altoona, WI 54720
Phone (715) 304-3683

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1841881307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 BLUESTEM BLVD STE C",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202619",
            "telephone_number": "715-304-3683",
            "fax_number": "715-304-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16301 KENRICK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448494",
            "telephone_number": "952-595-6337",
            "fax_number": "952-595-6336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 Bluestem Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "WI",
            "postal_code": "547202619",
            "country_code": "US",
            "telephone_number": "715-304-3683",
            "fax_number": "715-304-3679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMERICH",
        "first_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6798",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6143-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 9, 2024; 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.