William C. Gustafson, D.C., P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2782 Issued in MN

Legal business name

WILLIAM C. GUSTAFSON, D.C., P.A.

Practice address

199 Coon Rapids Blvd
Suite 315
Coon Rapids, MN 55433-5861

Phone

(763) 717-9510

Fax

(763) 717-2988

NPI assigned

Jun 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. William C Gustafson, D.C.NPI 1760449664

Title

President

Phone

(763) 717-9510

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William C Gustafson, D.C.

  • Chiropractor
  • Coon Rapids, MN
  • NPI 1760449664
  Medicare reassignment NPD Authorized official
• Ryan W. Nolte, D.C.

  • Chiropractor
  • Saint Paul, MN
  • NPI 1316336803
  NPD

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1548497340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD",
            "address_2": "SUITE 315",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335861",
            "telephone_number": "763-717-9510",
            "fax_number": "763-717-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD",
            "address_2": "SUITE 315",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335861",
            "telephone_number": "763-717-9510",
            "fax_number": "763-717-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C. GUSTAFSON, D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-717-9510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica K Wilbur, PSYD LP
• Laura B Wilczynski, NP
• Daniel Troy Wilder, PHARM.D.
• Suzzanne Wilhelm-Orth
• Diane Jane Willging
• Felicia Dwedi Williams
• Jada Monah Williams
• Marni Williams
• Valencia Yvonne Williams
• Allison Damon Willkom, DPM

• Chiropractor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.