Joseph Scott Gustafson Sr., LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

473055 Issued in WI

Practice address

1475 Hwy 65
Pain Management Acupuncture of St Croix
New Richmond, WI 54017

Phone

(715) 425-2694

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255452215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 PIKA TRAIL",
            "address_2": "UNIT A",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "54022",
            "telephone_number": "715-425-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 HWY 65",
            "address_2": "PAIN MANAGEMENT ACUPUNCTURE OF ST CROIX",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "54017",
            "telephone_number": "715-425-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "JOSEPH",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "473055",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Grahovac, MS, LPC-IT
• Great Lakes Oral & Maxillofacial Surgery, P.a.
• Ericka Green
• Chad James Griffith, M.D.
• Pamels Jo Grover, COTA
• Arthur A Haines, D.C.
• Christopher Hansen, PHARMD
• Bruce G Hanson, MD
• Stephen J Harrold, MD
• Heather Hawes

• Acupuncturist in New Richmond, WI
• Providers in New Richmond, WI by specialty
• Acupuncturist in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.