Individual provider Active NPI

Robert Joel Gustafson, DC

  • Neurology Chiropractor
  • Rochester, MN
National Provider Identifier
1205047800
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
3598 Issued in MN
Practice address
2215 2ND St SW
Suite 140
Rochester, MN 55902-4147
Phone
(507) 292-7784
Fax
(507) 226-8079
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 3598 MN Primary

Addresses

Primary practice location

2215 2ND St SW
Suite 140
Rochester, MN 55902-4147

Mailing address

1055 Plummer Cir SW
Rochester, MN 55902-2082
Phone (507) 292-7784

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
Southwest Chiropractic and Rehabilitation Services, PA Neurology PastSince Aug 28, 2011 Accepting new patients
Northgate Health Clinic, P.a. PastSince Sep 1, 2004 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1205047800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 PLUMMER CIR SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022082",
            "telephone_number": "507-292-7784",
            "fax_number": "507-226-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 2ND ST SW",
            "address_2": "SUITE 140",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024147",
            "telephone_number": "507-292-7784",
            "fax_number": "507-226-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "ROBERT",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "MN",
            "license": "3598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.