Individual provider Active NPI

Lynnita M Tigue-Petroski, DC

  • Chiropractor
  • Lords Valley, PA
National Provider Identifier
1922169200
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008740 Issued in PA
Practice address
98 Forest Dr
Suite 2
Lords Valley, PA 18428-6140
Phone
(570) 775-6205
Fax
(570) 775-6205
NPI assigned
Dec 12, 2006
Last updated
Mar 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 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 DC008740 PA Primary

Addresses

Primary practice location

98 Forest Dr
Suite 2
Lords Valley, PA 18428-6140

Mailing address

98 Forest Dr
Suite 2
Lords Valley, PA 18428-6140
Phone (570) 775-6205

Other identifiers 5

IdentifierTypeStateIssuer
818148OtherPAFIRST PRIORITY
056426TEXOtherPAMEDICARE PTAN
1012312930001MedicaidPA
1640258OtherPABLUE SHIELD
201331634OtherPATAX ID

Other names 1

  • Dr. Lynnita M Tigue Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000081 PA Practitioner - Chiropractic 3375506132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

662 Route 739
Lords Valley, PA 18428-6085

662 Route 739
Suite 2
Lords Valley, PA 18428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tigue Chiropractic Inc Chiropractor CurrentSince Jul 6, 2004 Accepting new patients
Professional Chiropractic Associates, P.C. Chiropractor PastSince Oct 1, 2007 Accepting new patients

Locations

662 Route 739
Ste 2
Lords Valley, PA 18428
Phone (570) 775-6205

98 Forest Dr
Ste 2
Lords Valley, PA 18428
Phone (570) 775-6205

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, 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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1922169200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 FOREST DR",
            "address_2": "SUITE 2",
            "city": "LORDS VALLEY",
            "state": "PA",
            "postal_code": "184286140",
            "telephone_number": "570-775-6205",
            "fax_number": "570-775-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 FOREST DR",
            "address_2": "SUITE 2",
            "city": "LORDS VALLEY",
            "state": "PA",
            "postal_code": "184286140",
            "telephone_number": "570-775-6205",
            "fax_number": "570-775-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIGUE-PETROSKI",
        "first_name": "LYNNITA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "818148",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "056426TEX",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012312930001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1640258",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "201331634",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNITA",
            "last_name": "TIGUE",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lords Valley, PA

Sources for this page

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