Jeremy Noel Gonzalez
Individual provider Active NPI Chiropractor · Lafayette, IN
NPI 1548078009 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1548078009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08003486A (IN)
- Practice address
- 12 Elston Rd
Lafayette, IN 47909-7000 - Phone
- (765) 477-7707
- NPI assigned
- Dec 30, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Goble Heal Chiropractic PC
Practice addresses (Care Compare)
12 Elston Rd
Renew Health Chiropractic
Lafayette, IN 47909-7000
Phone (765) 477-7707
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250816000332 | IN | Practitioner - Chiropractic | 8325547383 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goble Heal Chiropractic PC | Chiropractor | Current |
Accepting new patients |
Locations
12 Elston Rd
Lafayette, IN 47909
Phone (765) 477-7707
800 Main St
Rochester, IN 46975
Phone (574) 223-5557
1206 S Monticello St
Winamac, IN 46996
Phone (574) 946-4113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 08003486A | IN | Yes |
Addresses
Primary practice location
12 Elston Rd
Lafayette, IN 47909-7000
Mailing address
12 Elston Rd
Lafayette, IN 47909-7000
Phone (765) 477-7707
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. 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.