Individual provider Active NPI

Laura Lee Jonker, D.C.

  • Pediatric Chiropractor
  • Duluth, MN
National Provider Identifier
1609054030
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric ChiropractorTaxonomy code 111NP0017X
License
5340 Issued in MN
Practice address
1620 London Rd
Duluth, MN 55812-1619
Phone
(218) 269-1124
NPI assigned
Feb 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Chiropractor 111NP0017X 4346 WI
Pediatric Chiropractor 111NP0017X 5340 MN Primary

Addresses

Primary practice location

1620 London Rd
Duluth, MN 55812-1619

Mailing address

1620 London Rd
Duluth, MN 55812-1619
Phone (218) 269-1124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140226000113 MN Practitioner - Chiropractic 4981770617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1620 London Rd
Duluth, MN 55812-1619
Phone (218) 269-1124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4346WIMDPediatric Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jonker Chiropractic SC CurrentSince Jan 5, 2014 Accepting new patients
Lake Superior Chiropractic Office, S.C. Pediatric Chiropractor PastSince Nov 20, 2018 Accepting new patients
Northwoods Family Chiropractic Pediatric Chiropractor PastSince Jul 14, 2008 Accepting new patients
The Lakes Community Health Center, Inc Past Accepting new patients
Omnia Wellness and Recovery PastSince Oct 21, 2024 Accepting new patients

Locations

1620 London Rd
Duluth, MN 55812
Phone (218) 269-1124

1730 E Superior St
Ste 4
Duluth, MN 55812

Organizations & group practices 5

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": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1609054030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121619",
            "telephone_number": "218-269-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121619",
            "telephone_number": "218-269-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONKER",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "WI",
            "license": "4346",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "MN",
            "license": "5340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.