Organization Active NPI

Mantonya Chiropractic Center LLC

  • Chiropractor
  • Newark, OH
National Provider Identifier
1174983589
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MANTONYA CHIROPRACTIC CENTER LLC
Practice address
905 N 21St Street
Suite D
Newark, OH 43055-7251
Phone
(740) 366-6601
Fax
(740) 366-6286
NPI assigned
Feb 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Authorized official

Name
Gregg Allen Mantonya, D.C.NPI 1376516138
Title
Clinic Owner
Phone
(740) 366-6601

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

905 N 21St Street
Suite D
Newark, OH 43055-7251

Mailing address

905 N 21St Street
Suite D
Newark, OH 43055-7251
Phone (740) 366-6601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160503001276 OH Part B Supplier - Clinic/Group Practice 0941509509 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Hebron, OH; Newark, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mantonya Chiropractic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

149 N High St
Hebron, OH 43025
Phone (740) 928-7686

905 N 21st St
Ste D
Newark, OH 43055
Phone (740) 255-5189

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1174983589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N 21ST STREET",
            "address_2": "SUITE D",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430557251",
            "telephone_number": "740-366-6601",
            "fax_number": "740-366-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N 21ST STREET",
            "address_2": "SUITE D",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430557251",
            "telephone_number": "740-366-6601",
            "fax_number": "740-366-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTONYA CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "MANTONYA",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "740-366-6601",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.