Organization Active NPI

Winston-Salem Chiropractic, Inc

  • Chiropractor
  • Winston Salem, NC
National Provider Identifier
1073345740
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WINSTON-SALEM CHIROPRACTIC, INC
Practice address
2022 S Main St
Winston Salem, NC 27127-2934
Phone
(336) 724-0597
NPI assigned
Aug 20, 2024
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Jonathan Fonke, DCNPI 1912349382
Title
Ceo
Phone
(828) 292-1963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2022 S Main St
Winston Salem, NC 27127-2934

Mailing address

2022 S Main St
Winston Salem, NC 27127-2934
Phone (336) 724-0597

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241011001160 NC Part B Supplier - Clinic/Group Practice 2961934286 Receives reassigned benefits from 4 practitioners
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

2022 S Main St
Winston Salem, NC 27127
Phone (336) 724-0597

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1073345740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 S MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272934",
            "telephone_number": "336-724-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 S MAIN ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271272934",
            "telephone_number": "336-724-0597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINSTON-SALEM CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "FONKE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-292-1963",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.