Individual provider Active NPI

Jonathon Richard Nowakowski, DC

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1306479753
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH-12660 Issued in FL
Practice address
12231 E Colonial Dr Ste 110
Orlando, FL 32826-4759
Phone
(321) 204-2610
NPI assigned
Feb 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH-12660 FL Primary

Addresses

Primary practice location

12231 E Colonial Dr Ste 110
Orlando, FL 32826-4759

Mailing address

12231 E Colonial Dr Ste 110
Orlando, FL 32826-4759
Phone (321) 204-2610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011003568 FL Practitioner - Chiropractic 6709318975 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH-12660FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mauricio Chiropractic Clinics PA Chiropractor CurrentSince Sep 27, 2024 Accepting new patients
Mauricio Chiropractic East Colonial, LLC Chiropractor CurrentSince Sep 27, 2024 Accepting new patients
Mauricio Chiropractic Clinics PA Chiropractor CurrentSince Sep 27, 2024 Accepting new patients
Mauricio Chiropractic South L L C Chiropractor PastSince Aug 1, 2015 Accepting new patients

Locations

1050 N Pine Hills Rd
Orlando, FL 32808
Phone (407) 297-3666

12278 E Colonial Dr
Ste 700F
Orlando, FL 32826

12278 E Colonial Dr
Ste 700
Orlando, FL 32826
Phone (407) 272-7727

12278 E Colonial Dr
Ste 700E
Orlando, FL 32826

12278 E Colonial Dr
Orlando, FL 32826
Phone (407) 273-7727

Organizations & group practices 4

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": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1306479753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12231 E COLONIAL DR STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264759",
            "telephone_number": "321-204-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12231 E COLONIAL DR STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264759",
            "telephone_number": "321-204-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAKOWSKI",
        "first_name": "JONATHON",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH-12660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.