Active NPI
Wayne Erron Gudgel, D.C.
- Chiropractor
- Redwood Falls, MN
National Provider Identifier
1467445817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MN3465
- 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, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5C685GU | Other | MN | BLUE CROSS |
| 184715500 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
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
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8001749 | IN | MD | Chiropractor |
| MN3465 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillman Chiropractic P.C. | Chiropractor | Current | 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.
-
- Chiropractor
- Bloomington, IL
- NPI 1588934830
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.