Individual provider Active NPI

David Henry Fonke, D.C.

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1316955628
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2691 Issued in NC
Practice address
2018 Fort Bragg Rd
Suite 110a
Fayetteville, NC 28303-7037
Phone
(910) 850-9646
Fax
(910) 483-0676
NPI assigned
Aug 3, 2006
Last updated
Sep 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2691 NC Primary

Addresses

Primary practice location

2018 Fort Bragg Rd
Suite 110a
Fayetteville, NC 28303-7037

Mailing address

2018 Fort Bragg Rd
Suite 110a
Fayetteville, NC 28303-7037
Phone (910) 850-9646

Other identifiers 2

IdentifierTypeStateIssuer
0836UOtherNCBLUE CROSS BLUE SHIELD
8090836UMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040929000969 NC Practitioner - Chiropractic 6002885050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayetteville Chiropractic Solutions PAGroup PAC ID 5294185294, 3 clinicians

Practice addresses (Care Compare)

205 Owen Dr
Fayetteville, NC 28304-3409
Phone (910) 484-5999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fayetteville Chiropractic Solutions PA Chiropractor CurrentSince Jan 1, 2024 Accepting new patients
Chiropractic Health and Wellness Center, P. a. Chiropractor CurrentSince Mar 29, 2010 Accepting new patients

Locations

2018 Fort Bragg Rd
Ste 110A
Fayetteville, NC 28303
Phone (910) 273-0265

205 Owen Dr
Fayetteville, NC 28304
Phone (910) 484-5999

5414 Yadkin Rd
Fayetteville, NC 28303
Phone (910) 487-5010

Organizations & group practices 2

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1316955628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 FORT BRAGG RD",
            "address_2": "SUITE 110A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037037",
            "telephone_number": "910-850-9646",
            "fax_number": "910-483-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 FORT BRAGG RD",
            "address_2": "SUITE 110A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283037037",
            "telephone_number": "910-850-9646",
            "fax_number": "910-483-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONKE",
        "first_name": "DAVID",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0836U",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8090836U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.