Individual provider Active NPI

Kris Duane Gongaware, D.C.

  • Chiropractor
  • Gibsonia, PA
National Provider Identifier
1063555134
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-006022 Issued in PA
Practice address
5499 William Flynn Hwy
Gibsonia, PA 15044-9675
Phone
(724) 316-0717
Fax
(724) 443-6963
NPI assigned
Feb 15, 2007
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-006022 PA Primary

Addresses

Primary practice location

5499 William Flynn Hwy
Gibsonia, PA 15044-9675

Mailing address

3700 Sandy Hill Rd
Gibsonia, PA 15044-7784
Phone (724) 316-0717

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
DC-006022PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Spine Care Chiropractor CurrentSince Aug 6, 2021 Accepting new patients

Locations

5499 William Flynn Hwy
Gibsonia, PA 15044
Phone (724) 443-7143

5499 William Flynn Hwy
Ste 4
Gibsonia, PA 15044
Phone (724) 443-8444

Organizations & group practices 2

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1063555134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SANDY HILL RD",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150447784",
            "telephone_number": "724-316-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5499 WILLIAM FLYNN HWY",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449675",
            "telephone_number": "724-316-0717",
            "fax_number": "724-443-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGAWARE",
        "first_name": "KRIS",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-006022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.