Provider Demographics
NPI:1619993441
Name:LOTT, GREGORY STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:STEVEN
Last Name:LOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 A ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4283
Mailing Address - Country:US
Mailing Address - Phone:402-489-0777
Mailing Address - Fax:402-489-0874
Practice Address - Street 1:7111 A ST STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4283
Practice Address - Country:US
Practice Address - Phone:402-489-0777
Practice Address - Fax:402-489-0874
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1002OtherSTATE OF NE LICENSE
NE4400054OtherUNITED HEALTHCARE ID
NE127271OtherCOVENTRY PROVIDER ID
NE36623OtherBLUE CROSS PROVIDER NUMBE
NE47080455500Medicaid
NE350040889OtherMEDICARE RAILROAD
NE4400054OtherUNITED HEALTHCARE ID
NE268191Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER