Organization Active NPI

Gouker Chiropractic Clinic, P.C.

  • Rehabilitation Chiropractor
  • Uniontown, PA
National Provider Identifier
1114058088
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC007421L Issued in PA
Legal business name
GOUKER CHIROPRACTIC CLINIC, P.C.
Practice address
15 Metro PLZ
Uniontown, PA 15401-5407
Phone
(724) 437-8800
Fax
(724) 437-8805
NPI assigned
Mar 9, 2007
Last updated
Jul 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Authorized official

Name
Mrs. Courtney Beth Gouker
Title
Secretary
Phone
(724) 437-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC007421L PA Primary

Addresses

Primary practice location

15 Metro PLZ
Uniontown, PA 15401-5407

Mailing address

15 Metro PLZ
Uniontown, PA 15401-5407
Phone (724) 437-8800

Other identifiers 1

IdentifierTypeStateIssuer
01788791MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050427000050 PA Part B Supplier - Clinic/Group Practice 4688613995 Receives reassigned benefits from 1 practitioner
Practice locations: Uniontown, PA

National Provider Directory

National Provider Directory

Locations

15 Metro Plz
Uniontown, PA 15401
Phone (724) 437-8800

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278460800000",
    "number": "1114058088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 METRO PLZ",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015407",
            "telephone_number": "724-437-8800",
            "fax_number": "724-437-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 METRO PLZ",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015407",
            "telephone_number": "724-437-8800",
            "fax_number": "724-437-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOUKER CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-07-07",
        "status": "A",
        "authorized_official_last_name": "GOUKER",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "724-437-8800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "PA",
            "license": "DC007421L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01788791",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.