NPIMap

Organization Active NPI

Gutshall Clinic of Chiropractic P.C.

  • Chiropractor
  • Cameron, MO
National Provider Identifier
1659567857
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
003906 Issued in MO
Legal business name
GUTSHALL CLINIC OF CHIROPRACTIC P.C.
Practice address
602 Lana Dr
Suite a
Cameron, MO 64429-1473
Phone
(816) 632-6611
Fax
(816) 632-6612
NPI assigned
Sep 20, 2007
Last updated
Oct 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Dr. Roger G Gutshall, D.C.NPI 1396745824
Title
President
Phone
(816) 632-6611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 003906 MO Primary

Addresses

Primary practice location

602 Lana Dr
Suite a
Cameron, MO 64429-1473

Mailing address

602 Lana Dr
Suite a
Cameron, MO 64429-1473
Phone (816) 632-6611

Other identifiers 1

IdentifierTypeStateIssuer
75346700MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1659567857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 LANA DR",
            "address_2": "SUITE A",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644291473",
            "telephone_number": "816-632-6611",
            "fax_number": "816-632-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 LANA DR",
            "address_2": "SUITE A",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644291473",
            "telephone_number": "816-632-6611",
            "fax_number": "816-632-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTSHALL CLINIC OF CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "GUTSHALL",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-632-6611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "003906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75346700",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.