Derek Goracke, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6566 Issued in MN

Practice address

510 22ND Ave E Ste 701
Alexandria, MN 56308-4817

Phone

(320) 763-9711

NPI assigned

Jan 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Lakes Chiropractic Clinic PCGroup PAC ID 5698725448, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Central Lakes Chiropractic Clinic PC

  • Chiropractor
  • Alexandria, MN
  • NPI 1902861339
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1546300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546300800000",
    "number": "1104398171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 22ND AVE E STE 701",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084817",
            "telephone_number": "320-763-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 22ND AVE E STE 701",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084817",
            "telephone_number": "320-763-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORACKE",
        "first_name": "DEREK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-01",
        "last_updated": "2019-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon Michael Godfrey, D.C.
• Justin Godfrey, D.C.
• Marc Howard Godfrey, D.C.
• Angela Marie Goergen, RN
• David Allen Golke
• Kristin K Goracke, MA
• Katie Renee Gorecki
• Kandice Laray Gorres, LADC
• Grand St Paul CVS LLC
• Connie M Gratias, FNP

• Chiropractor in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2019; 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.