Organization Active NPI

Lifetree Chiropractic & Wellness, LLC

  • Chiropractor
  • Shoreview, MN
National Provider Identifier
1871979245
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3899 Issued in MN
Legal business name
LIFETREE CHIROPRACTIC & WELLNESS, LLC
Practice address
3550 Lexington Ave N Ste 210
Shoreview, MN 55126-8092
Phone
(651) 308-2917
NPI assigned
Aug 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Authorized official

Name
Dr. Lori D. Lukovsky, D.C.NPI 1730201435
Title
Owner/Chiropractor
Phone
(651) 308-2917

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 3899 MN Primary

Addresses

Primary practice location

3550 Lexington Ave N Ste 210
Shoreview, MN 55126-8092

Mailing address

3550 Lexington Ave N Ste 210
Shoreview, MN 55126-8092

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151005000687 MN Part B Supplier - Clinic/Group Practice 5395053748 Receives reassigned benefits from 1 practitioner
Practice locations: Shoreview, MN

National Provider Directory

National Provider Directory

Locations

3550 Lexington Ave N
Ste 210
Shoreview, MN 55126
Phone (651) 308-2917

Practitioners & affiliated clinicians

Practitioners 1

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": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1871979245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 LEXINGTON AVE N STE 210",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 LEXINGTON AVE N STE 210",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268092",
            "telephone_number": "651-308-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETREE CHIROPRACTIC & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "LUKOVSKY",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "651-308-2917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.