NORTHERN LAKES CHIROPRACTIC CLINIC, P.C.
NPI 1710156443
Chiropractor in Ponderay, ID
About Northern Lakes Chiropractic Clinic, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHERN LAKES CHIROPRACTIC CLINIC, P.C. (NPI 1710156443) is a healthcare organization registered as a chiropractor in Ponderay, Idaho and active in the NPI registry since February 2008. The organization lists Ryan Leisy, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northern Lakes Chiropractic Clinic, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Northern Lakes Chiropractic Clinic, P.C., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Northern Lakes Chiropractic Clinic, P.C.'s NPI number?
The NPI number for Northern Lakes Chiropractic Clinic, P.C. is 1710156443. It was assigned to this organization in the NPPES registry on February 27, 2008.
Where is Northern Lakes Chiropractic Clinic, P.C. located?
Northern Lakes Chiropractic Clinic, P.C. is located at 30544 Highway 200 Ste 330, Ponderay, ID 83852. The listed phone number is (208) 265-1900.
What is Northern Lakes Chiropractic Clinic, P.C.'s specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Northern Lakes Chiropractic Clinic, P.C. enrolled in Medicare?
Yes. Northern Lakes Chiropractic Clinic, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northern Lakes Chiropractic Clinic, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Northern Lakes Chiropractic Clinic, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Northern Lakes Chiropractic Clinic, P.C. was last updated on March 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Northern Lakes Chiropractic Clinic, P.c. · NPI 1710156443
Chiropractor organization in Ponderay, Idaho. Organization record, active in the CMS NPPES registry since February 27, 2008.
## Identity
- **NPI:** 1710156443 (Entity type: Organization)
- **Enumerated:** February 27, 2008
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Ryan Leisy, CEO
## Practice location
- **Address:** 30544 HIGHWAY 200 STE 330, Ponderay, ID 83852-5005
- **Phone:** (208) 265-1900 · **Fax:** (208) 227-8313
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 29, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1710156443) · Data from the CMS NPPES public registry.