Individual provider Active NPI

Russell Matthew Gana, D.C.

  • Chiropractor
  • Austin, TX
National Provider Identifier
1063743557
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11283 Issued in TX
Practice address
1825 Fortview Rd Ste 104
Austin, TX 78704-7600
Phone
(512) 829-1549
NPI assigned
Jan 22, 2010
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11283 TX Primary

Addresses

Primary practice location

1825 Fortview Rd Ste 104
Austin, TX 78704-7600

Mailing address

1825 Fortview Rd Ste 104
Austin, TX 78704-7600
Phone (512) 829-1549

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gana Specific Chiropractic PLLC Chiropractor CurrentSince Mar 30, 2010 Accepting new patients
C1C2 PLLC Chiropractor PastSince Mar 3, 2018 Accepting new patients

Locations

1825 Fortview Rd
Ste 104
Austin, TX 78704
Phone (512) 829-1549

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": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1063743557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 FORTVIEW RD STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047600",
            "telephone_number": "512-829-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 FORTVIEW RD STE 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047600",
            "telephone_number": "512-829-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANA",
        "first_name": "RUSSELL",
        "middle_name": "MATTHEW",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-22",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.