Individual provider Active NPI

John Lesueur, D.C.

  • Chiropractor
  • Eden, NC
National Provider Identifier
1891269643
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4993 Issued in NC
Practice address
405 Boone Rd
Eden, NC 27288-4967
Phone
(336) 627-7398
NPI assigned
Jan 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4993 NC Primary

Addresses

Primary practice location

405 Boone Rd
Eden, NC 27288-4967

Mailing address

405 Boone Rd
Eden, NC 27288-4967

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190409000772 NC Practitioner - Chiropractic 3678814266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John R. Dabbs Jr. DC PCGroup PAC ID 9931290574, 2 clinicians

Practice addresses (Care Compare)

405 Boone Rd
Eden, NC 27288-4967
Phone (336) 627-7398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4993NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John R. Dabbs Jr. DC PC Chiropractor CurrentSince Apr 3, 2019 Accepting new patients
Protherapy Concepts, Inc. PastSince Jan 15, 2023 Accepting new patients

Locations

405 Boone Rd
Eden, NC 27288
Phone (336) 627-7398

723 S Van Buren Rd
Eden, NC 27288

723 S Van Buren Rd
Ste C
Eden, NC 27288
Phone (336) 627-7398

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": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1891269643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BOONE RD",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272884967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BOONE RD",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272884967",
            "telephone_number": "336-627-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESUEUR",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.