Blue Wing Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BLUE WING CHIROPRACTIC

Practice address

2100 Main St Ste 202
Longmont, CO 80501-1590

Phone

(720) 340-4435

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Michael Maczko, DCNPI 1669959870

Title

Co-Owner

Phone

(720) 340-4435

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathan Maczko

  • Chiropractor
  • Longmont, CO
  • NPI 1669959870
  Authorized official Same address or phone
• Kendra Louise Grace Fitzke, DC

  • Chiropractor
  • Longmont, CO
  • NPI 1457838104
  NPD

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1366101297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MAIN ST STE 202",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011590",
            "telephone_number": "720-340-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MAIN ST STE 202",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011590",
            "telephone_number": "720-340-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WING CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "MACZKO",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "720-340-4435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457838104",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669959870",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanara Dawn Block, RDH
• Lily Sepha Blodgett
• Annette Bloom, CMT, NCBTMB
• Jennifer Bloom, MS, PT
• Taryn Nicole Bloomfield
• Laura Rose Boccia
• Gary Bock, RPH
• Body Affects, LLC
• Bodypoint Medicine
• Brian Edward Boehm, MA, LPC

• Chiropractor in Longmont, CO
• Providers in Longmont, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.