NPIMap

Organization Active NPI

Gunderman Chiropractic & Wellness LLC

  • Chiropractor
  • Yorktown, VA
National Provider Identifier
1033223433
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000549 Issued in VA
Legal business name
GUNDERMAN CHIROPRACTIC & WELLNESS LLC
Practice address
5701 George Washington Mem Hwy
Yorktown, VA 23692-2773
Phone
(757) 874-5666
Fax
(757) 874-8625
NPI assigned
Aug 19, 2006
Last updated
Apr 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
Samuel J Gunderman Jr., D.C.
Title
Business Owner, Chiropractor
Phone
(757) 874-5666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000549 VA Primary

Addresses

Primary practice location

5701 George Washington Mem Hwy
Yorktown, VA 23692-2773

Mailing address

PO Box 982
Yorktown, VA 23692-0982
Phone (757) 874-5666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130220000450 VA Part B Supplier - Clinic/Group Practice 5890940985 Receives reassigned benefits from 3 practitioners
Practice locations: Yorktown, VA

National Provider Directory

National Provider Directory

Locations

5701 George Washington Mem Hwy
Yorktown, VA 23692
Phone (757) 874-5666

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1033223433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 982",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236920982",
            "telephone_number": "757-874-5666",
            "fax_number": "757-874-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 GEORGE WASHINGTON MEM HWY",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236922773",
            "telephone_number": "757-874-5666",
            "fax_number": "757-874-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERMAN CHIROPRACTIC & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "GUNDERMAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS OWNER, CHIROPRACTOR",
        "authorized_official_telephone_number": "757-874-5666",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.