Active NPI
Michael Stephen Zvonar III, D.C.
- Chiropractor
- Chisago City, MN
National Provider Identifier
1669525754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 003667
- Practice address
- 11494 Brink Ave
Chisago City, MN 55013-9411 - Phone
- (651) 257-3914
- Fax
- (651) 257-3915
- NPI assigned
- Jan 19, 2007
- 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 | 003667 | MN | Primary |
Addresses
Primary practice location
11494 Brink Ave
Chisago City, MN 55013-9411
Mailing address
11494 Brink Ave
Chisago City, MN 55013-9411
Phone (651) 257-3914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55P79ZV | Other | MN | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003667 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669525754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11494 BRINK AVE",
"city": "CHISAGO CITY",
"state": "MN",
"postal_code": "550139411",
"telephone_number": "651-257-3914",
"fax_number": "651-257-3915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11494 BRINK AVE",
"city": "CHISAGO CITY",
"state": "MN",
"postal_code": "550139411",
"telephone_number": "651-257-3914",
"fax_number": "651-257-3915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZVONAR",
"first_name": "MICHAEL",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "003667",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "55P79ZV",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chisago City, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.