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JACK V, LUNDBOHM INC
NPI 1780822486
Clinic/Center in Roseau, MN

Active since February 03, 2009
317 2ND ST NW, SUITE A, ROSEAU, MN 56751(218) 463-2992(218) 463-1229 Get Directions Write a Review

NPPES record last updated: February 3, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jack V, Lundbohm Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK V, LUNDBOHM INC (NPI 1780822486) is a healthcare organization registered as a clinic/center in Roseau, Minnesota and active in the NPI registry since February 2009. The organization lists Jack V Lundbohm, President, as its authorized official.

NPPES Registry Identity

NPI1780822486
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameJACK V, LUNDBOHM INC
Location Address317 2ND ST NW, SUITE ARoseau, MN 56751-1070
Mailing Address317 2nd St Nw, Suite ARoseau, MN 56751-1070 · (218) 463-2992 · Fax (218) 463-1229
Phone(218) 463-2992
Fax(218) 463-1229
Organization SubpartNo
Authorized OfficialJack V LundbohmPresident · (218) 463-2992
Enumeration DateFebruary 3, 2009
✔ NPI 1780822486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in MN · 1792
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
317 2ND ST NW, Roseau, MN 56751
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack V, Lundbohm Inc 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 Jack V, Lundbohm Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jack Lundbohm
Chiropractic
NPI 1275632234
317 2ND ST NW STE A
Roseau, MN 56751
(218) 463-2992
✔ Accepts MedicareSame address

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 Jack V, Lundbohm Inc's NPI number?

The NPI number for Jack V, Lundbohm Inc is 1780822486. It was assigned to this organization in the NPPES registry on February 3, 2009.

Where is Jack V, Lundbohm Inc located?

Jack V, Lundbohm Inc is located at 317 2nd St NW Suite A, Roseau, MN 56751. The listed phone number is (218) 463-2992.

What is Jack V, Lundbohm Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Jack V, Lundbohm Inc enrolled in Medicare?

Yes. Jack V, Lundbohm Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jack V, Lundbohm Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Jack V, Lundbohm Inc. 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 Jack V, Lundbohm Inc was last updated on February 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.