Gregory Todd Lackey, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034332 Issued in WA

Practice address

13800 NE 20TH Ave
Vancouver, WA 98686-2704

Phone

(360) 574-5944

Fax

(360) 574-6430

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Opdahl Chiropractic Office Inc.Group PAC ID 7810973104, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Opdahl Chiropractic Office Inc.

  • Chiropractor
  • Battle Ground, WA
  • NPI 1134315781
  Medicare reassignment Care Compare group
• The Chiro Clinic Longview PLLC

  • Chiropractor
  • Longview, WA
  • NPI 1255201091
  Medicare reassignment NPD

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1932125333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824",
            "fax_number": "630-468-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862704",
            "telephone_number": "360-574-5944",
            "fax_number": "360-574-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "GREGORY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL L & I",
            "identifier": "122681300",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L & I",
            "identifier": "184778",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• L Katherine Moon
• Corinne Beth La Fors
• Todd Robert La Rock, D.O.
• Jaime Anne La Tona, LH61531731
• Labtran Clinical Laboratories, LLC
• Kristie Ann Lackey, PTA
• Louellen Louise Lacombe
• Robin Lacosse, LMP
• Anna Shane Ladd, MA
• Jennifer N Laddusaw, LMP

• Chiropractor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.