NPIMap

Organization Active NPI

Lake City Chiropractic, LTD.

  • Chiropractor
  • Lake City, MN
National Provider Identifier
1992879134
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3W422 Issued in MN
Legal business name
LAKE CITY CHIROPRACTIC, LTD.
Practice address
127 S High St
Lake City, MN 55041-1637
Phone
(651) 345-3361
Fax
(651) 345-4049
NPI assigned
Nov 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leroy Frank Otto, D.C.NPI 1497813083
Title
President
Phone
(651) 345-3361

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3W422 MN Primary

Addresses

Primary practice location

127 S High St
Lake City, MN 55041-1637

Mailing address

127 S High St
Lake City, MN 55041-1637
Phone (651) 345-3361

National Provider Directory

National Provider Directory

Locations

127 S High St
Lake City, MN 55041
Phone (651) 345-3361

Practitioners & affiliated clinicians

Practitioners 1

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992879134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S HIGH ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411637",
            "telephone_number": "651-345-3361",
            "fax_number": "651-345-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S HIGH ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411637",
            "telephone_number": "651-345-3361",
            "fax_number": "651-345-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY CHIROPRACTIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OTTO",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-345-3361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3W422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.