NPIMap

Individual provider Active NPI

Douglas Joseph Gendron, DC

  • Chiropractor
  • Springfield, MA
National Provider Identifier
1487768040
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2005 Issued in MA
Practice address
438 Chestnut St
Springfield, MA 01107
Phone
(413) 746-0504
Fax
(413) 746-0508
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2005 MA Primary

Addresses

Primary practice location

438 Chestnut St
Springfield, MA 01107

Mailing address

438 Chestnut St
Springfield, MA 01107
Phone (413) 746-0504

Other identifiers 10

IdentifierTypeStateIssuer
1028952OtherFALLON
3065316OtherAETNA
Y36679OtherBCBS MASS INDEMNITY
1601229OtherMASS HEALTH MEDICAID
1601229MedicaidMA
665295OtherACN GROUP
Y45483OtherMEDICARE MASS AREA 99
Y36679OtherBCBS MASS HMO
665295OtherACN
Y36679OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Express Urgent Care Center, Co. Inc. PastSince Feb 6, 2013 Accepting new patients
Advanced Spine Centers, Inc Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487768040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01107",
            "telephone_number": "413-746-0504",
            "fax_number": "413-746-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01107",
            "telephone_number": "413-746-0504",
            "fax_number": "413-746-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDRON",
        "first_name": "DOUGLAS",
        "middle_name": "JOSEPH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1028952",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3065316",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MASS INDEMNITY",
            "identifier": "Y36679",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH MEDICAID",
            "identifier": "1601229",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1601229",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "665295",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MASS AREA 99",
            "identifier": "Y45483",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MASS HMO",
            "identifier": "Y36679",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "665295",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y36679",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.