Lakeside Sports Chiropractic Center - Medicare in Cornelius, NC

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Lakeside Sports Chiropractic Center is a medicare enrolled "Clinic/center - Multi-specialty" provider in Cornelius, North Carolina. Their current practice location is 19924 Jetton Rd Ste 101, Cornelius, North Carolina. You can reach out to their office (for appointments etc.) via phone at (704) 896-8446.

Lakeside Sports Chiropractic Center is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Lakeside Sports Chiropractic Center is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1033125240.

Contact Information

Lakeside Sports Chiropractic Center
19924 Jetton Rd Ste 101,
Cornelius, NC 28031-8253
(704) 896-8446
(704) 896-8495

Map and Direction




Healthcare Provider's Profile

Full NameLakeside Sports Chiropractic Center
TypeFacility
SpecialityClinic/center - Multi-specialty
Location19924 Jetton Rd Ste 101, Cornelius, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1033125240
  • Provider Enumeration Date: 07/31/2006
  • Last Update Date: 05/17/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8921012709
  • Enrollment ID: O20060131000927

Medical Identifiers

Medical identifiers for Lakeside Sports Chiropractic Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033125240NPI-NPPES
89085RMMedicaidNC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor 3249 (North Carolina)Secondary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lakeside Sports Chiropractic Center acts as a billing entity for following providers:
Provider NameJennifer M Lidstrom
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1073618708
PECOS PAC ID: 1759356991
Enrollment ID: I20040831000820
Provider NameLuis Alejandro Rosado
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1124430301
PECOS PAC ID: 9739474834
Enrollment ID: I20181116000586
Provider NameSuzanne Dudko
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1538246897
PECOS PAC ID: 8224060652
Enrollment ID: I20200610003057
Provider NameJames Hughes
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1063055697
PECOS PAC ID: 0042622581
Enrollment ID: I20201208000024
Provider NameBrian Otis Nappier
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1437678877
PECOS PAC ID: 2062829468
Enrollment ID: I20210401000075
Provider NameDakota Powell Vance
Provider TypePractitioner - Chiropractic
Provider IdentifiersNPI Number: 1194480053
PECOS PAC ID: 6204225048
Enrollment ID: I20211116002057

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lakeside Sports Chiropractic Center is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lakeside Sports Chiropractic Center
19924 Jetton Rd Ste 101,
Cornelius, NC 28031-8253

Ph: (704) 896-8446		Lakeside Sports Chiropractic Center
19924 Jetton Rd Ste 101,
Cornelius, NC 28031-8253

Ph: (704) 896-8446

Reviews and Comments



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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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