Individual provider Active NPI

Jodi Lee Zinnen-Nowak, DC

  • Chiropractor
  • Monroe, MI
National Provider Identifier
1023107661
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007106 Issued in MI
Practice address
2100 S Custer Rd
Monroe, MI 48161-9701
Phone
(734) 241-4500
Fax
(734) 241-4602
NPI assigned
Oct 12, 2006
Last updated
Apr 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007106 MI Primary

Addresses

Primary practice location

2100 S Custer Rd
Monroe, MI 48161-9701

Mailing address

2100 S Custer Rd
Monroe, MI 48161-9701
Phone (734) 241-4500

Other identifiers 2

IdentifierTypeStateIssuer
950E810830OtherBCBS
4815050MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050422000625 MI Practitioner - Chiropractic 4385682178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2100 S Custer Rd
Monroe, MI 48161-9701
Phone (734) 241-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301007106MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Zinnen Chiropractic PLLC Chiropractor CurrentSince May 20, 2005 Accepting new patients
Awan and Associates PC Past Accepting new patients
Porter & Clark Chiropractic PLLC Chiropractor PastSince Jan 1, 2003 Accepting new patients

Locations

2100 S Custer Rd
Monroe, MI 48161
Phone (734) 241-4500

910 S Telegraph Rd
Monroe, MI 48161
Phone (734) 241-4500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1023107661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S CUSTER RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619701",
            "telephone_number": "734-241-4500",
            "fax_number": "734-241-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S CUSTER RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619701",
            "telephone_number": "734-241-4500",
            "fax_number": "734-241-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINNEN-NOWAK",
        "first_name": "JODI",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950E810830",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4815050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.