Jay D Koontz, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001901A Issued in IN

Practice address

118 S Main St
North Webster, IN 46555

Phone

(574) 834-7855

Fax

(574) 834-7935

NPI assigned

Dec 12, 2006

Last updated

Feb 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lakeland Spinal Health PC

  • Chiropractor
  • North Webster, IN
  • NPI 1215258546
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1801956404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "NORTH WEBSTER",
            "state": "IN",
            "postal_code": "465550579",
            "telephone_number": "574-834-7855",
            "fax_number": "574-834-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "NORTH WEBSTER",
            "state": "IN",
            "postal_code": "46555",
            "telephone_number": "574-834-7855",
            "fax_number": "574-834-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "JAY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001901A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000210120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn R. Glock, MA, LMHC
• Goshen Health System, Inc (Goshen Physicians)
• Amanda Shay Herendeen, LSW
• Dawn Hoffert
• Sena Kaufman, MA, LMHC
• Kosciusko County Free Clinic, Inc
• Gabriel P Koser, MA, MDIV
• Lakeland Spinal Health PC
• Kendall Marie Littlefield
• Sarah Elizabeth Mock

• Chiropractor in North Webster, IN
• Providers in North Webster, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.