NPIMap

Organization Active NPI

Gary a. Goerg, DC, PA

Doing business as Back Pain Institute of Port Charlotte

  • Chiropractor
  • Port Charlotte, FL
National Provider Identifier
1346481520
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7167 Issued in FL
Legal business name
GARY A. GOERG, DC, PA
Doing business as
Back Pain Institute of Port Charlotte
Practice address
2496 Caring Way
Unit B
Port Charlotte, FL 33952-5336
Phone
(941) 235-3535
Fax
(941) 235-3550
NPI assigned
Mar 17, 2009
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Dr. Gary Anton Goerg, D.C.NPI 1285848325
Title
President
Phone
(941) 235-3535

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 CH7167 FL Primary

Addresses

Primary practice location

2496 Caring Way
Unit B
Port Charlotte, FL 33952-5336

Mailing address

2496 Caring Way
Unit B
Port Charlotte, FL 33952-5336
Phone (941) 235-3535

Other identifiers 3

IdentifierTypeStateIssuer
U63581OtherFLUPIN PER CCN: 920515184914
K8198OtherFLGROUP IDENTIFICATION NUMBER PER CCN:920515184914
55458ZOtherFLPROVIDER NUMBER PER CCN: 920515184914

Other names 1

  • Back Pain Institute of Port Charlotte Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1346481520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 CARING WAY",
            "address_2": "UNIT B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525336",
            "telephone_number": "941-235-3535",
            "fax_number": "941-235-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2496 CARING WAY",
            "address_2": "UNIT B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525336",
            "telephone_number": "941-235-3535",
            "fax_number": "941-235-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY A. GOERG, DC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "GOERG",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ANTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-235-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN PER CCN: 920515184914",
            "identifier": "U63581",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IDENTIFICATION NUMBER  PER CCN:920515184914",
            "identifier": "K8198",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER PER CCN: 920515184914",
            "identifier": "55458Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back Pain Institute of Port Charlotte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.