DR. KIMBERLY SUE LAKE (D.C.) – Chiropractor, NPI 1376594713

DR. KIMBERLY SUE LAKE (D.C.) is a healthcare provider. based in Davenport, Iowa. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 06869 (IA). The NPI Number for DR. KIMBERLY SUE LAKE (D.C.) is 1376594713

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. KIMBERLY SUE LAKE (D.C.)
NPI
1376594713
Phone
(563) 344-0777
Address
4626 PROGRESS DR STE D
Enumeration Date
12 May 2006
Last Update Date
23 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2006 (20 years ago)
PAC ID
5799797882
Group Practice PAC ID
9739190828
Professional Enrollment ID
I20060607000099
Address ID
IA528073485DA4626XDXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,215 CHIROPRACTIC in IA

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Provider Addresses for DR. KIMBERLY SUE LAKE (D.C.)

  • 4626 PROGRESS DR STE D

    DAVENPORT, IA 528073485

    Phone: (563) 344-0777

    Fax: (563) 344-0888

    Type: Mailing

  • 2525, Kimberly Road, Bettendorf, Scott County, Iowa, 52722, United States

    STE #1

    BETTENDORF, IA 527223538

    Phone: (563) 344-0777

    Fax: (563) 344-0888

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-06-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060607000099IChiropracticIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions23534$0
View full utilization report →

Insurance plans in this area (ZIP 52807)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739190828View full group profile
NameSpecialtyState
C H I R O P R A C T I CKS
C H I R O P R A C T I CIA

Reviews

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Frequently asked questions

What federal number belongs to DR. KIMBERLY SUE LAKE (D.C.)?
The federal identifier for DR. KIMBERLY SUE LAKE (D.C.) is NPI 1376594713.
Is DR. KIMBERLY SUE LAKE (D.C.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. KIMBERLY SUE LAKE (D.C.) treat or focus on?
Patients typically see DR. KIMBERLY SUE LAKE (D.C.) under the specialty Chiropractor. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. KIMBERLY SUE LAKE (D.C.)?
The page summarizes Davenport, Iowa for DR. KIMBERLY SUE LAKE (D.C.); expand the address list for detail.
What if Davenport, Iowa seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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