Organization Active NPI

Lucas Chiro Clinic Inc

Doing business as Lucas Enterprises

  • Neurology Chiropractor
  • Wasilla, AK
National Provider Identifier
1962553131
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
89 Issued in AK
Legal business name
LUCAS CHIRO CLINIC INC
Doing business as
Lucas Enterprises
Practice address
1261 S Seward Meridian Rd
Suite F
Wasilla, AK 99654-8334
Phone
(907) 357-6101
Fax
(907) 357-6102
NPI assigned
Jan 15, 2007
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Dr. Bobby A Lucas, D.CNPI 1790811081
Title
President
Phone
(907) 357-6100

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
Neurology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN0400X 89 AK Primary

Addresses

Primary practice location

1261 S Seward Meridian Rd
Suite F
Wasilla, AK 99654-8334

Mailing address

1261 S Seward Meridian Rd
Suite F
Wasilla, AK 99654-8334
Phone (907) 357-6101

Other identifiers 3

IdentifierTypeStateIssuer
CH0054MedicaidAK
CH0217MedicaidAK
CHG031MedicaidAK

Other names 1

  • Lucas Enterprises Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713000170 AK Part B Supplier - Clinic/Group Practice 1951389246 Receives reassigned benefits from 2 practitioners
Practice locations: Wasilla, AK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1962553131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 S SEWARD MERIDIAN RD",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548334",
            "telephone_number": "907-357-6101",
            "fax_number": "907-357-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 S SEWARD MERIDIAN RD",
            "address_2": "SUITE F",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548334",
            "telephone_number": "907-357-6101",
            "fax_number": "907-357-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCAS CHIRO CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-357-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "AK",
            "license": "89",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0054",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH0217",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CHG031",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucas Enterprises",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.