Mary J Gonstead, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2063-012 Issued in WI

Practice address

431 E Clairemont Ave
Eau Claire, WI 54701-3685

Phone

(715) 832-2223

Fax

(715) 832-7416

NPI assigned

Jul 26, 2005

Reactivated

Mar 24, 2006

Last updated

Oct 9, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr MJ Gonstead LLC

  • Chiropractor
  • Eau Claire, WI
  • NPI 1598002487
  Medicare reassignment NPD Authorized official
• Eau Claire Spine & Orthopedics, SC

  • Orthopaedic Surgery of the Spine Physician
  • Eau Claire, WI
  • NPI 1811936248
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1508866161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016479",
            "telephone_number": "715-832-2223",
            "fax_number": "715-832-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547013685",
            "telephone_number": "715-832-2223",
            "fax_number": "715-832-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSTEAD",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2018-10-09",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2063-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "391744596019",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350010622",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Ride Transportation LLC
• Joseph S. Goldsmith, OD
• Nancy Jean Gonderzik
• Jennifer Gonstead, D.C.
• Karah Sue Gonstead, LCSW
• Caesar R. Gonzaga, MD
• Michael Gonzaga, MD
• Scott David Gooch, PA
• Amanda Goodbear, LPN
• Katherine Mary Goodenough, APNP

• Chiropractor in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.