Individual provider Active NPI

Cary L Gundlach, DC

  • Chiropractor
  • Gilbert, AZ
National Provider Identifier
1336245554
Registry record updated Jan 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8053 Issued in AZ
Practice address
3530 S Val Vista Dr
Ste A111
Gilbert, AZ 85297-7319
Phone
(480) 878-5480
Fax
(480) 696-3807
NPI assigned
Sep 15, 2006
Last updated
Jan 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8053 AZ Primary
Chiropractor 111N00000X 3575-012 WI

Addresses

Primary practice location

3530 S Val Vista Dr
Ste A111
Gilbert, AZ 85297-7319

Mailing address

3530 S Val Vista Dr
Ste A111
Gilbert, AZ 85297-7319
Phone (480) 878-5480

Other identifiers 1

IdentifierTypeStateIssuer
38910600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110414000948 AZ Practitioner - Chiropractic 6901709369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3575-012WIMDChiropractor
8053AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thorp Family Chiropractic LLC Chiropractor Past Accepting new patients
Allied Health of Wisconsin, SC Chiropractor Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21206/brand/1/csg/1/fhir/r4

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, 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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1336245554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 S VAL VISTA DR",
            "address_2": "STE A111",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977319",
            "telephone_number": "480-878-5480",
            "fax_number": "480-696-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 S VAL VISTA DR",
            "address_2": "STE A111",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977319",
            "telephone_number": "480-878-5480",
            "fax_number": "480-696-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDLACH",
        "first_name": "CARY",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8053",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3575-012",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38910600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2020; 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.