Individual provider Active NPI

Christopher Michael Gubbels, DC

  • Chiropractor
  • Fort Collins, CO
National Provider Identifier
1437313509
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR 6256 Issued in CO
Practice address
257 E Boardwalk Dr
Fort Collins, CO 80525-5931
Phone
(970) 207-4046
Fax
(970) 207-4052
NPI assigned
Jul 17, 2008
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR 6256 CO Primary

Addresses

Primary practice location

257 E Boardwalk Dr
Fort Collins, CO 80525-5931

Mailing address

257 E Boardwalk Dr
Fort Collins, CO 80525-5931
Phone (970) 207-4046

Other identifiers 1

IdentifierTypeStateIssuer
COB4123OtherCOMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081006000633 CO Practitioner - Chiropractic 4981772738 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHR 6256COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Scoliosis Clinic Chiropractor CurrentSince Sep 14, 2024 Accepting new patients
Square One Health LLC CurrentSince Nov 16, 2020 Accepting new patients

Locations

257 Boardwalk Dr
Fort Collins, CO 80525
Phone (970) 207-4046

257 Boardwalk Dr
#One
Fort Collins, CO 80525
Phone (970) 207-4463

8601 Turnpike Dr
Ste 206
Westminster, CO 80031
Phone (303) 955-1919

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1437313509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 E BOARDWALK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255931",
            "telephone_number": "970-207-4046",
            "fax_number": "970-207-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 E BOARDWALK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255931",
            "telephone_number": "970-207-4046",
            "fax_number": "970-207-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBBELS",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR 6256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "COB4123",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.