Kristan Wayne Jonasson, DC
Individual provider Active NPI Chiropractor · Thomasville, NC
NPI 1306988720 · NPPES record last updated Apr 24, 2013
Key facts
- NPI
- 1306988720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2712 (NC)
- Practice address
- 13 Cloniger Dr
Suite 5
Thomasville, NC 27360-5870 - Phone
- (336) 476-9600
- Fax
- (336) 476-9636
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13 Cloniger Dr
Suite 5
Thomasville, NC 27360-5871
Phone (336) 476-9600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041101001212 | NC | Practitioner - Chiropractic | 6305808569 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2712 | NC | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cassandra Loeffler PLLC | Chiropractor | Current |
Accepting new patients |
Locations
13 Cloniger Dr
Ste 5
Thomasville, NC 27360
Phone (336) 476-9600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2712 | NC | Yes |
Addresses
Primary practice location
13 Cloniger Dr
Suite 5
Thomasville, NC 27360-5870
Mailing address
PO Box 1184
Thomasville, NC 27361
Phone (336) 476-9600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890840U | Medicaid | NC | |
| 0840U | Other | NC | BLUE CROSS BLUE SHIELD |
Other providers in Thomasville, NC
- Pamela Willette Johnson
- Rebecca Lee Johnson
- Aaron Kyle Johnston
- Grace Moore Jonasson
- Koby Jonasson
- Candice Jones
- Daniel Hall Jones
- Sarah Nance Jones
- Thania Juarez
- Beatriz Juncadella
All providers in Thomasville, NC · Chiropractor in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.