Individual provider Active NPI

Lance Mollenhauer, D.C.

  • Chiropractor
  • Florence, AZ
National Provider Identifier
1912206590
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8189 Issued in AZ
Practice address
700 N. Pinal Parkway
Florence, AZ 85132
Phone
(520) 868-3605
Fax
(480) 813-2987
NPI assigned
Mar 21, 2011
Last updated
Apr 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8189 AZ Primary

Addresses

Primary practice location

700 N. Pinal Parkway
Florence, AZ 85132

Mailing address

PO Box 2298
Florence, AZ 85132-3043
Phone (520) 868-3605

Other identifiers 2

IdentifierTypeStateIssuer
Z150398OtherPTAN
Z150399OtherAZPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120215000865 AZ Practitioner - Chiropractic 1658539952 Practice locations: Florence, AZ; Mesa, AZ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
University of Wisconsin School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4111 E Valley Auto Dr
Suite 201
Mesa, AZ 85206-4609
Phone (602) 696-9071

700 N Pinal Pkwy
Florence, AZ 85132
Phone (520) 868-3605

PO Box
Suite 2298
Florence, AZ 85132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clouse Chiropractic Clinic LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1912206590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2298",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851323043",
            "telephone_number": "520-868-3605",
            "fax_number": "480-813-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N. PINAL PARKWAY",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "85132",
            "telephone_number": "520-868-3605",
            "fax_number": "480-813-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLENHAUER",
        "first_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z150398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z150399",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.