Individual provider Active NPI

Gregory Alan Sander, D.C.

  • Chiropractor
  • Estherville, IA
National Provider Identifier
1629127048
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05143 Issued in IA
Practice address
508 W Central Ave
Estherville, IA 51334-1834
Phone
(712) 362-7715
Fax
(712) 362-7716
NPI assigned
Jan 9, 2007
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05143 IA Primary

Addresses

Primary practice location

508 W Central Ave
Estherville, IA 51334-1834

Mailing address

508 W Central Ave
Estherville, IA 51334-1834
Phone (712) 362-7715

Other practice location 1

15 S 9th St
Estherville, IA 51334-2220
Phone (712) 362-4139

Other identifiers 1

IdentifierTypeStateIssuer
0243089MedicaidIA

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

508 W Central Ave
Esterville, IA 51334-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sander Chiropractic PastSince Jan 1, 1990 Accepting new patients

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1629127048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 W CENTRAL AVE",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341834",
            "telephone_number": "712-362-7715",
            "fax_number": "712-362-7716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 W CENTRAL AVE",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341834",
            "telephone_number": "712-362-7715",
            "fax_number": "712-362-7716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 S 9th St",
            "address_purpose": "LOCATION",
            "city": "Estherville",
            "state": "IA",
            "postal_code": "513342220",
            "country_code": "US",
            "telephone_number": "712-362-4139",
            "fax_number": "712-362-8818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDER",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243089",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estherville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.