Individual provider Active NPI

Kevin Patrick Jonca, D.C.

  • Chiropractor
  • Monroe, MI
National Provider Identifier
1720118722
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009044 Issued in MI
Practice address
14930 Laplaisance Rd
Suite #116
Monroe, MI 48161-3880
Phone
(734) 242-4422
Fax
(734) 242-6774
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009044 MI Primary

Addresses

Primary practice location

14930 Laplaisance Rd
Suite #116
Monroe, MI 48161-3880

Mailing address

14930 Laplaisance Rd
Suite #116
Monroe, MI 48161-3880
Phone (734) 242-4422

Other identifiers 1

IdentifierTypeStateIssuer
KJ009044OtherMIBCBS- INDIVIDUAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140224000423 MI Practitioner - Chiropractic 7416965520 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009044MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
DCG Holdings PLLC Chiropractor CurrentSince Aug 9, 2021 Accepting new patients
Progressive Guidance Center of Monroe PLLC Past Accepting new patients
Masters Chiropractic, P.C. Chiropractor PastSince Nov 3, 2005 Accepting new patients

Locations

8336 Hilton Rd
Ste 100
Brighton, MI 48114
Phone (810) 225-2288

Organizations & group practices 3

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1720118722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14930 LAPLAISANCE RD",
            "address_2": "SUITE #116",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481613880",
            "telephone_number": "734-242-4422",
            "fax_number": "734-242-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14930 LAPLAISANCE RD",
            "address_2": "SUITE #116",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481613880",
            "telephone_number": "734-242-4422",
            "fax_number": "734-242-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONCA",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS- INDIVIDUAL",
            "identifier": "KJ009044",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.