Individual provider Active NPI

Jonathan David Schnelle, D.C.

  • Chiropractor
  • Boulder, CO
National Provider Identifier
1205999141
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5537 Issued in CO
Practice address
2919 Valmont Rd
Suite 104
Boulder, CO 80301-1350
Phone
(303) 442-2126
Fax
(303) 444-0665
NPI assigned
Dec 19, 2006
Last updated
Feb 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5537 CO Primary

Addresses

Primary practice location

2919 Valmont Rd
Suite 104
Boulder, CO 80301-1350

Mailing address

2919 Valmont Rd
Suite 104
Boulder, CO 80301-1350
Phone (303) 442-2126

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000751 CO Practitioner - Chiropractic 6709875701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3405 Penrose PL
Suite 205
Boulder, CO 80301-1820
Phone (303) 442-2126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5537COMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Chiropractic & Wellness Center LLC Chiropractor CurrentSince Jan 28, 2014 Accepting new patients

Locations

2919 Valmont Rd
Ste 104
Boulder, CO 80301
Phone (303) 442-2126

3405 Penrose Pl
Ste 205
Boulder, CO 80301
Phone (303) 442-2126

Organizations & group practices 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1205999141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 VALMONT RD",
            "address_2": "SUITE 104",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011350",
            "telephone_number": "303-442-2126",
            "fax_number": "303-444-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 VALMONT RD",
            "address_2": "SUITE 104",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011350",
            "telephone_number": "303-442-2126",
            "fax_number": "303-444-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNELLE",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.