NPIMap

Organization Active NPI

Goforth Chiropractic Life Center, P.C.

  • Chiropractor
  • Gallup, NM
National Provider Identifier
1043407919
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
433 Issued in NM
Legal business name
GOFORTH CHIROPRACTIC LIFE CENTER, P.C.
Practice address
108 W Hill Ave
Gallup, NM 87301-6218
Phone
(505) 722-9002
Fax
(505) 722-7031
NPI assigned
Sep 25, 2007
Last updated
Sep 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Dr. Forrest Wayne Goforth, D.C.NPI 1598833287
Title
Dr/Owner/Operator
Phone
(505) 722-9002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 433 NM Primary

Addresses

Primary practice location

108 W Hill Ave
Gallup, NM 87301-6218

Mailing address

108 W Hill Ave
Gallup, NM 87301-6218
Phone (505) 722-9002

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1043407919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W HILL AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016218",
            "telephone_number": "505-722-9002",
            "fax_number": "505-722-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W HILL AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016218",
            "telephone_number": "505-722-9002",
            "fax_number": "505-722-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOFORTH CHIROPRACTIC LIFE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "GOFORTH",
        "authorized_official_first_name": "FORREST",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DR/OWNER/OPERATOR",
        "authorized_official_telephone_number": "505-722-9002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.