Individual provider Active NPI

Gary Bryce Gamache, DC FIAMA DIPL AC

  • Chiropractor
  • Rapid City, SD
National Provider Identifier
1104826866
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
572 Issued in SD
Practice address
2720 W Main St
Rapid City, SD 57702-8128
Phone
(605) 342-4333
Fax
(605) 348-6420
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 572 SD Primary
Acupuncturist 171100000X 572 SD

Addresses

Primary practice location

2720 W Main St
Rapid City, SD 57702-8128

Mailing address

2720 W Main St
Rapid City, SD 57702-8128
Phone (605) 342-4333

Other identifiers 2

IdentifierTypeStateIssuer
0085088OtherSDWELLMARK BCBS
7600140MedicaidSD

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
572SDMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1104826866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 W MAIN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028128",
            "telephone_number": "605-342-4333",
            "fax_number": "605-348-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 W MAIN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028128",
            "telephone_number": "605-342-4333",
            "fax_number": "605-348-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMACHE",
        "first_name": "GARY",
        "middle_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "DC FIAMA DIPL AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "572",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "SD",
            "license": "572",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "0085088",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600140",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.