Individual provider Active NPI

Matthew Gronewold, D.C.

  • Chiropractor
  • Pella, IA
National Provider Identifier
1366836389
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
077153 Issued in IA
Practice address
110 E 10TH St
Pella, IA 50219-2002
Phone
(641) 780-4192
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 077153 IA Primary

Addresses

Primary practice location

110 E 10TH St
Pella, IA 50219-2002

Mailing address

110 E 10TH St
Pella, IA 50219-2002
Phone (641) 780-4192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150518001350 IA Practitioner - Chiropractic 5193045045 Reassigns benefits to 1 organization
Practice locations: Waterloo, IA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intentional Chiropractic PCGroup PAC ID 3577032846, 2 clinicians

Practice addresses (Care Compare)

3640 Canterbury CT
Waterloo, IA 50702-5705
Phone (319) 486-1169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077153IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Waterloo Chiropractic Center PLLC Chiropractor CurrentSince Jan 20, 2022 Accepting new patients
Intentional Chiropractic PC Chiropractor Current Accepting new patients
Browne Family Chiropractic PC Chiropractor PastSince Feb 18, 2008 Accepting new patients

Locations

3731 Kimball Ave
Waterloo, IA 50702
Phone (319) 231-4779

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1366836389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 10TH ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502192002",
            "telephone_number": "641-780-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 10TH ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502192002",
            "telephone_number": "641-780-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONEWOLD",
        "first_name": "MATTHEW",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "077153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.