Organization Active NPI

Lang Chiropractic Clinic PA

  • Chiropractor
  • Brainerd, MN
National Provider Identifier
1861591737
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LANG CHIROPRACTIC CLINIC PA
Practice address
413 S 6TH St
Brainerd, MN 56401-3539
Phone
(218) 828-4418
Fax
(218) 828-4575
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Jay K Lang, DCNPI 1457465288
Title
Owner
Phone
(218) 828-4418

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X MN Primary

Addresses

Primary practice location

413 S 6TH St
Brainerd, MN 56401-3539

Mailing address

413 S 6TH St
Brainerd, MN 56401-3539
Phone (218) 828-4418

Other identifiers 1

IdentifierTypeStateIssuer
140160200MedicaidMN

Other names 1

  • Lakes Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000040 MN Part B Supplier - Clinic/Group Practice 0446205983 Receives reassigned benefits from 3 practitioners
Practice locations: Brainerd, MN

National Provider Directory

National Provider Directory

Locations

413 S 6th St
Brainerd, MN 56401
Phone (218) 828-4418

423 Laurel St
Brainerd, MN 56401
Phone (218) 828-4418

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1861591737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013539",
            "telephone_number": "218-828-4418",
            "fax_number": "218-828-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013539",
            "telephone_number": "218-828-4418",
            "fax_number": "218-828-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANG CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-828-4418",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140160200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakes Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.