Individual provider Active NPI

Lisa Hannifin, DC

  • Chiropractor
  • Chatsworth, CA
National Provider Identifier
1972664662
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27439 Issued in CA
Practice address
21036 Vintage St
Chatsworth, CA 91311-3054
Phone
(818) 437-5337
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27439 CA Primary

Addresses

Primary practice location

21036 Vintage St
Chatsworth, CA 91311-3054

Mailing address

21036 Vintage St
Chatsworth, CA 91311-3054
Phone (818) 437-5337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050518000621 CA Practitioner - Chiropractic 6507807716 Practice locations: Chatsworth, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21036 Vintage St
Chatsworth, CA 91311-3054
Phone (818) 437-5337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27439CAMDClinical Social Worker
DC27439CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michele S Colon DPM a Professional Podiatry Corp Past Accepting new patients
Axis Chiropractic Chiropractor Past Accepting new patients

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1972664662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21036 VINTAGE ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113054",
            "telephone_number": "818-437-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21036 VINTAGE ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113054",
            "telephone_number": "818-437-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNIFIN",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; 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.