Randy Robert Johnson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4635 Issued in MN

Practice address

1706 East Tenth Street
Gauer Chiropractic Clinic
Glencoe, MN 55336

Phone

(320) 864-3196

Fax

(320) 864-3197

NPI assigned

Dec 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gauer Chiropractic Clinic PAGroup PAC ID 7416905815, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gauer Chiropractic Clinic PA

  • Chiropractor
  • Glenoce, MN
  • NPI 1821150178
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124180450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 EAST TENTH STREET",
            "address_2": "GAUER CHIROPRACTIC CLINIC",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-3196",
            "fax_number": "320-864-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 EAST TENTH STREET",
            "address_2": "GAUER CHIROPRACTIC CLINIC",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-3196",
            "fax_number": "320-864-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RANDY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.