NPIMap

Individual provider Active NPI

Gregory John Mongeon, DC

  • Chiropractor
  • Lincoln, NE
National Provider Identifier
1063530830
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1558 Issued in NE
Practice address
2855 S 70TH St
Ste 101
Lincoln, NE 68506-3700
Phone
(402) 483-4300
Fax
(402) 483-7789
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4427 MN
Chiropractor 111N00000X 038011535 IL
Chiropractor 111N00000X 1558 NE Primary

Addresses

Primary practice location

2855 S 70TH St
Ste 101
Lincoln, NE 68506-3700

Mailing address

2855 S 70TH St
Ste 101
Lincoln, NE 68506-3700
Phone (402) 483-4300

Other identifiers 2

IdentifierTypeStateIssuer
782696600MedicaidMN
10025835600MedicaidNE

Other names 1

  • Dr. Gregory John Mongeon Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4427MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center of West Chicago LLC Chiropractor Past Accepting new patients
Cornerstone Medical Center PastSince Jan 1, 2014 Accepting new patients
Bradlee N Novotny, D.C., P.C. Chiropractor PastSince May 5, 2008 Accepting new patients
Cornerstone Therapy Centre, PC Past Accepting new patients
Eilrich Family Chiropractic & Wellness Chiropractor Past Accepting new patients
Mankato Institute of Wellness Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1063530830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 S 70TH ST",
            "address_2": "STE 101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063700",
            "telephone_number": "402-483-4300",
            "fax_number": "402-483-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 S 70TH ST",
            "address_2": "STE 101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063700",
            "telephone_number": "402-483-4300",
            "fax_number": "402-483-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGEON",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4427",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011535",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782696600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025835600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "MONGEON",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.