Lyle L Lauritsen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1398 Issued in WI

Practice address

214 Spruce St
Spooner, WI 54801

Phone

(715) 635-6969

Fax

(715) 635-6946

NPI assigned

Oct 20, 2006

Last updated

Jul 26, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1977

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1861574543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "address_2": "214 SPRUCE ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "54801",
            "telephone_number": "715-635-6969",
            "fax_number": "715-635-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 SPRUCE ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "54801",
            "telephone_number": "715-635-6969",
            "fax_number": "715-635-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURITSEN",
        "first_name": "LYLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38750500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larson Chiropractic Office Inc
• Danielle Nicole Larson, M.A. CCC-SLP
• Erik Lee Larson, D.P.T.
• Randy Obert Larson, DC
• Vicki L Larson, NCTMB
• Robert Lindberg, RN
• Jessica Marker
• Patrick J McCann, MD
• Bradley Allwin McDonald, MD
• Sarah Kramer McDonald, MD

• Chiropractor in Spooner, WI
• Providers in Spooner, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.