Active NPI
Jaime Gonzalez, DC
- Chiropractor
- Louisville, KY
National Provider Identifier
1669443859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5135
- Practice address
- 10110 Dixie Hwy
Louisville, KY 40272-3948 - Phone
- (502) 937-7995
- Fax
- (503) 937-5560
- NPI assigned
- Jan 27, 2006
- Last updated
- Nov 4, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5135 | KY | Primary |
Addresses
Primary practice location
10110 Dixie Hwy
Louisville, KY 40272-3948
Mailing address
10110 Dixie Hwy
Louisville, KY 40272-3948
Phone (502) 937-7995
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100072710 | Medicaid | KY | |
| K030550 | Other | KY | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10110 Dixie Hwy
Louisville, KY 40272-3948
Phone (502) 937-7995
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5135 | KY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Qfour, Inc. | Chiropractor | Past | Accepting new patients |
| Sparlin Healthcare | Past | Accepting new patients | |
| Christopher Brookes | Chiropractor | Past | Accepting new patients |
| Lighthouse Chiropractic Center | Chiropractor | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Flowery Branch, GA
- NPI 1790845857
-
dba Lighthouse Chiropractic Center, LLC
- Chiropractor
- Flowery Branch, GA
- NPI 1780857771
-
- Clinic/Center
- Atlanta, GA
- NPI 1124567201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1669443859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10110 DIXIE HWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402723948",
"telephone_number": "502-937-7995",
"fax_number": "503-937-5560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10110 DIXIE HWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402723948",
"telephone_number": "502-937-7995",
"fax_number": "503-937-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JAIME",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "5135",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100072710",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "K030550",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.