Active NPI
Gary Dean Wheelock, DC
- Chiropractor
- Grand Rapids, MN
National Provider Identifier
1043221203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1288
- Practice address
- 605 NW 4TH St
Grand Rapids, MN 55744-2301 - Phone
- (218) 326-2714
- Fax
- (218) 326-2219
- NPI assigned
- Aug 11, 2006
- Last updated
- Aug 31, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1288 | MN | Primary |
Addresses
Primary practice location
605 NW 4TH St
Grand Rapids, MN 55744-2301
Mailing address
605 NW 4TH St
Grand Rapids, MN 55744-2301
Phone (218) 326-2714
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73550WH | Other | MN | BCBS |
| 767325600 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251676800000",
"number": "1043221203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 NW 4TH ST",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557442301",
"telephone_number": "218-326-2714",
"fax_number": "218-326-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 NW 4TH ST",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557442301",
"telephone_number": "218-326-2714",
"fax_number": "218-326-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELOCK",
"first_name": "GARY",
"middle_name": "DEAN",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2009-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1288",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "73550WH",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "767325600",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.