Individual provider Active NPI

Gregg A. Mantonya, D.C.

  • Chiropractor
  • Newark, OH
National Provider Identifier
1376516138
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3023 Issued in OH
Practice address
919 N 21St St
Newark, OH 43055-2919
Phone
(740) 366-6601
Fax
(740) 366-6286
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3023 OH Primary

Addresses

Primary practice location

919 N 21St St
Newark, OH 43055-2919

Mailing address

919 N 21St St
Newark, OH 43055-2919
Phone (740) 366-6601

Other identifiers 4

IdentifierTypeStateIssuer
2190016MedicaidOH
310811048031OtherOHCARESOURCE
350050808OtherOHPALMETTO GBA RR MEDICARE
000000211465OtherOHANTHEM BC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071109000397 OH Practitioner - Chiropractic 2567550452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mantonya Chiropractic Center LLCGroup PAC ID 0941509509, 4 clinicians

Practice addresses (Care Compare)

149 N High St
Hebron, OH 43025-9669
Phone (740) 928-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3023OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mantonya Chiropractic Center LLC Chiropractor CurrentSince May 1, 2016 Accepting new patients
Mantonya Chiropractic Center LLC Chiropractor CurrentSince May 1, 2016 Accepting new patients

Locations

149 N High St
Hebron, OH 43025
Phone (740) 928-7686

919 N 21st St
Newark, OH 43055
Phone (740) 366-3139

905 N 21st St
Ste D
Newark, OH 43055
Phone (740) 255-5189

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1376516138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552919",
            "telephone_number": "740-366-6601",
            "fax_number": "740-366-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N 21ST ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552919",
            "telephone_number": "740-366-6601",
            "fax_number": "740-366-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTONYA",
        "first_name": "GREGG",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2190016",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "310811048031",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RR MEDICARE",
            "identifier": "350050808",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000211465",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.