Individual provider Active NPI

Jonathan Vincent Fonke, D.C.

  • Chiropractor
  • Greensboro, NC
National Provider Identifier
1912349382
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4413 Issued in NC
Practice address
2006 New Garden Rd
Ste. 204
Greensboro, NC 27410-2566
Phone
(336) 545-3132
Fax
(336) 545-0571
NPI assigned
Jul 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4413 NC Primary

Addresses

Primary practice location

2006 New Garden Rd
Ste. 204
Greensboro, NC 27410-2566

Mailing address

2006 New Garden Rd
Ste. 204
Greensboro, NC 27410-2566
Phone (336) 545-3132

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029001165 NC Practitioner - Chiropractic 6507091501 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Chiropractic IncGroup PAC ID 3476698309, 4 clinicians
Winston-Salem Chiropractic IncGroup PAC ID 2961934286, 3 clinicians

Practice addresses (Care Compare)

2006 New Garden Rd
Suite 204
Greensboro, NC 27410-2568
Phone (336) 545-3132

2022 S Main St
Winston Salem, NC 27127-2934
Phone (336) 724-0597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4413NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Winston-Salem Chiropractic, Inc Chiropractor CurrentSince Aug 20, 2024 Accepting new patients
Durham Chiropractic Clinic Inc Chiropractor Current Accepting new patients
Burlington Chiropractic, Inc Chiropractor CurrentSince May 23, 2023 Accepting new patients
Brugger Chiropractic, PLLC Chiropractor CurrentSince May 23, 2023 Accepting new patients

Locations

3008 S Church St
Ste A
Burlington, NC 27215
Phone (336) 584-9932

2022 S Main St
Winston Salem, NC 27127
Phone (336) 724-0597

Organizations & group practices 5

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": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1912349382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 NEW GARDEN RD",
            "address_2": "STE. 204",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102566",
            "telephone_number": "336-545-3132",
            "fax_number": "336-545-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 NEW GARDEN RD",
            "address_2": "STE. 204",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102566",
            "telephone_number": "336-545-3132",
            "fax_number": "336-545-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONKE",
        "first_name": "JONATHAN",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.