Individual provider Active NPI

Paul Hermann Gasch, D.C.

  • Chiropractor
  • Onalaska, WI
National Provider Identifier
1063629509
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4965-12 Issued in WI
Practice address
1115 Riders Club Rd
Onalaska, WI 54650-2079
Phone
(608) 519-8112
Fax
(608) 519-8113
NPI assigned
May 16, 2007
Last updated
Oct 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4965-12 WI Primary
Nutrition Chiropractor 111NN1001X 761-0406 NH

Addresses

Primary practice location

1115 Riders Club Rd
Onalaska, WI 54650-2079

Mailing address

925 13TH Ave S
Ste 100
Onalaska, WI 54650-3417
Phone (608) 519-8112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415002205 WI Practitioner - Chiropractic 9739244807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

925 13TH Ave S
Suite 100
Onalaska, WI 54650-3417
Phone (608) 519-8112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4965-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Onalaska Family Chiropractic Wellness Center LLC Chiropractor CurrentSince Sep 2, 2015 Accepting new patients
Progressive Spine Care LLC Chiropractor Past Accepting new patients

Locations

1115 Riders Club Rd
Onalaska, WI 54650
Phone (608) 519-2606

925 13th Ave S
Ste 100
Onalaska, WI 54650
Phone (608) 519-8112

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1063629509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 13TH AVE S",
            "address_2": "STE 100",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546503417",
            "telephone_number": "608-519-8112",
            "fax_number": "608-519-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 RIDERS CLUB RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546502079",
            "telephone_number": "608-519-8112",
            "fax_number": "608-519-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASCH",
        "first_name": "PAUL",
        "middle_name": "HERMANN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4965-12",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NH",
            "license": "761-0406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; 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.