Individual provider Active NPI

Wayne Erron Gudgel, D.C.

  • Chiropractor
  • Redwood Falls, MN
National Provider Identifier
1467445817
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MN3465 Issued in MN
Practice address
821 E Bridge St
Redwood Falls, MN 56283-1801
Phone
(507) 637-8585
Fax
(507) 637-8649
NPI assigned
Aug 31, 2005
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

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 MN3465 MN Primary
Chiropractor 111N00000X 8001749 IN

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
5C685GUOtherMNBLUE CROSS
184715500MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200604002865 IL Practitioner - Chiropractic 0648469577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillman Chiropractic PCGroup PAC ID 8628245404, 5 clinicians

Practice addresses (Care Compare)

2406 E Washington St
Bloomington, IL 61704-4410
Phone (309) 585-0704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
8001749INMDChiropractor
MN3465MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hillman Chiropractic P.C. Chiropractor CurrentSince Jan 11, 2020 Accepting new patients

Locations

2406 E Washington St
Bloomington, IL 61704
Phone (309) 585-0704

Organizations & group practices 1

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1467445817",
    "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": "WAYNE",
        "middle_name": "ERRON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "MN3465",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "8001749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5C685GU",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184715500",
            "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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.