Active NPI
Austin Gottschalk, DO
- Surgery Physician
- Cannon Afb, NM
National Provider Identifier
1629644489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- UNKNOWN
- Practice address
- 224 W D. L. Ingram Avenue BLDG. 1408
Cannon Afb, NM 88103 - Phone
- (575) 904-6942
- NPI assigned
- Jun 2, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | UNKNOWN | TX | Primary |
Addresses
Primary practice location
224 W D. L. Ingram Avenue BLDG. 1408
Cannon Afb, NM 88103
Mailing address
1962 E Sunset Dr
Layton, UT 84040-5711
Phone (801) 671-6294
Other practice location 1
7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 567-7000
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UNKNOWN | TX | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1629644489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1962 E SUNSET DR",
"city": "LAYTON",
"state": "UT",
"postal_code": "840405711",
"telephone_number": "801-671-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 W D. L. INGRAM AVENUE BLDG. 1408",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88103",
"telephone_number": "575-904-6942"
}
],
"practiceLocations": [
{
"address_1": "7703 Floyd Curl Dr",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782293901",
"country_code": "US",
"telephone_number": "210-567-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOTTSCHALK",
"first_name": "AUSTIN",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-02",
"last_updated": "2023-12-04",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "UNKNOWN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cannon Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.