Shannon Lee Bonczyk, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

012357 Issued in NY

Practice address

7133 W Main Rd Ste 1
Le Roy, NY 14482-9380

Phone

(585) 813-5157

Fax

(585) 510-4527

NPI assigned

Apr 12, 2013

Last updated

Apr 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon Lee Wright Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesee Country Chiropractic PLLC

  • Chiropractor
  • Le Roy, NY
  • NPI 1932807955
  Medicare reassignment NPD Authorized official
• Odell Family Chiropractic PC

  • Chiropractor
  • Webster, NY
  • NPI 1952525578
  Medicare reassignment NPD

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1043653652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7133 W MAIN RD",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144829380",
            "telephone_number": "585-639-4652",
            "fax_number": "585-510-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7133 W MAIN RD STE 1",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144829380",
            "telephone_number": "585-813-5157",
            "fax_number": "585-510-4527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Metro Park Ste 1",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146232653",
            "country_code": "US",
            "telephone_number": "585-639-4652",
            "fax_number": "585-510-4527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONCZYK",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WRIGHT",
            "middle_name": "LEE",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Chiropractor in Le Roy, NY
• Providers in Le Roy, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.