Individual provider Active NPI

Gregory Tonnesen, DC

  • Chiropractor
  • Saint Johns, FL
National Provider Identifier
1811633100
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14015 Issued in FL
Practice address
2050 Saint Johns Pkwy Ste 107
Saint Johns, FL 32259-4593
Phone
(704) 310-1985
NPI assigned
May 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14015 FL Primary

Addresses

Primary practice location

2050 Saint Johns Pkwy Ste 107
Saint Johns, FL 32259-4593

Mailing address

2050 Saint Johns Pkwy Ste 107
Saint Johns, FL 32259-4593
Phone (704) 310-1985

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106002792 FL Practitioner - Chiropractic 5193195121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2050 Saint Johns Pkwy
Suite 107
Saint Johns, FL 32259-4593
Phone (904) 990-6776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
100 Chiro Tonnesen Chiropractor CurrentSince Dec 14, 2022 Accepting new patients

Locations

2050 Saint Johns Pkwy
Ste 107
St Johns, FL 32259
Phone (704) 310-1985

Organizations & group practices 1

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": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1811633100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 SAINT JOHNS PKWY STE 107",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594593",
            "telephone_number": "704-310-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SAINT JOHNS PKWY STE 107",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594593",
            "telephone_number": "704-310-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONNESEN",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.