Individual provider Active NPI

James Walker Gudgel, D.C.

  • Chiropractor
  • Redwood Falls, MN
National Provider Identifier
1265435812
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1888 Issued in MN
Practice address
821 E Bridge St
Redwood Falls, MN 56283-1801
Phone
(507) 637-8585
Fax
(507) 637-8649
NPI assigned
May 27, 2005
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1888 MN Primary
Physical Therapist 225100000X 5776 MN

Addresses

Primary practice location

821 E Bridge St
Redwood Falls, MN 56283-1801

Mailing address

821 E Bridge St
Redwood Falls, MN 56283-1801
Phone (507) 637-8585

Other identifiers 2

IdentifierTypeStateIssuer
47209GUOtherMNBLUE CROSS
784527800MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028000474 MN Practitioner - Chiropractic 8325088453 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1888MNMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Redwood Chiropractic PSC Chiropractor CurrentSince Jan 1, 2022 Accepting new patients
Activator Health Center Chiropractor Past Accepting new patients

Locations

821 E Bridge St
Redwood Falls, MN 56283
Phone (507) 637-8585

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1265435812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E BRIDGE ST",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "562831801",
            "telephone_number": "507-637-8585",
            "fax_number": "507-637-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E BRIDGE ST",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "562831801",
            "telephone_number": "507-637-8585",
            "fax_number": "507-637-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDGEL",
        "first_name": "JAMES",
        "middle_name": "WALKER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1888",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "47209GU",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "784527800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.