NPIMap

Organization Active NPI

Gonstead Family Chiropractic of Abq - Westside, Inc

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1205988060
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1290 Issued in NM
Legal business name
GONSTEAD FAMILY CHIROPRACTIC OF ABQ - WESTSIDE, INC
Practice address
1632 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone
(505) 922-9444
Fax
(505) 922-9150
NPI assigned
Jan 18, 2007
Last updated
Nov 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Dr. Michael Rozenblum, DCNPI 1689765406
Title
President
Phone
(505) 922-9444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1290 NM Primary

Addresses

Primary practice location

1632 Alameda Blvd NW
Albuquerque, NM 87114-8807

Mailing address

1632 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone (505) 922-9444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090917000222 NM Part B Supplier - Clinic/Group Practice 3173679040 Receives reassigned benefits from 3 practitioners
Practice locations: Rio Rancho, NM

National Provider Directory

National Provider Directory

Locations

1920 Westside Blvd SE
Rio Rancho, NM 87124
Phone (505) 922-9444

1920 Westside Blvd SE
Ste A
Rio Rancho, NM 87124
Phone (505) 922-9444

Practitioners & affiliated clinicians

Practitioners 6

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1205988060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148807",
            "telephone_number": "505-922-9444",
            "fax_number": "505-922-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148807",
            "telephone_number": "505-922-9444",
            "fax_number": "505-922-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONSTEAD FAMILY CHIROPRACTIC OF ABQ - WESTSIDE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "ROZENBLUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-922-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.