Individual provider Active NPI

Leon Gonyo, D.C.

  • Chiropractor
  • Stuart, FL
National Provider Identifier
1700924859
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9076 Issued in FL
Practice address
6096 SE Federal Hwy
Stuart, FL 34997-8101
Phone
(772) 781-0193
Fax
(772) 781-0197
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9076 FL Primary

Addresses

Primary practice location

6096 SE Federal Hwy
Stuart, FL 34997-8101

Mailing address

6096 SE Federal Hwy
Stuart, FL 34997-8101
Phone (772) 781-0193

Other identifiers 1

IdentifierTypeStateIssuer
AI166ZOtherFLPTAN

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

LicenseStateTypeSpecialty
8349TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Resources, LLC PastSince Nov 14, 2007 Accepting new patients
Jose L Gradilla Chiropractor Past Accepting new patients

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1700924859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6096 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349978101",
            "telephone_number": "772-781-0193",
            "fax_number": "772-781-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6096 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349978101",
            "telephone_number": "772-781-0193",
            "fax_number": "772-781-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONYO",
        "first_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "AI166Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.