Individual provider Active NPI

Jeffrey Thomas Gullickson, DC

  • Chiropractor
  • Hopkins, MN
National Provider Identifier
1205894672
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2937 Issued in MN
Practice address
17 Tenth Ave S
Hopkins, MN 55343-7505
Phone
(952) 927-6639
Fax
(952) 927-0178
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2937 MN Primary

Addresses

Primary practice location

17 Tenth Ave S
Hopkins, MN 55343-7505

Mailing address

17 Tenth Ave S
Hopkins, MN 55343-7505
Phone (952) 927-6639

Other identifiers 1

IdentifierTypeStateIssuer
42G86GUOtherMNBC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000059 MN Practitioner - Chiropractic 0143221192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17 10TH Ave S
Hopkins, MN 55343-7505
Phone (952) 927-0019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2937MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopkins Chiropractic PA Chiropractor CurrentSince May 22, 2016 Accepting new patients

Locations

17 10th Ave S
Hopkins, MN 55343
Phone (952) 541-5669

Organizations & group practices 1

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205894672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 TENTH AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437505",
            "telephone_number": "952-927-6639",
            "fax_number": "952-927-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 TENTH AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437505",
            "telephone_number": "952-927-6639",
            "fax_number": "952-927-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLICKSON",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "42G86GU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkins, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.