NPIMap

Organization Active NPI

Gonstead Family Chiropractic of Albuquerque, P.C.

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1669525168
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1290 Issued in NM
Legal business name
GONSTEAD FAMILY CHIROPRACTIC OF ALBUQUERQUE, P.C.
Practice address
8001 Wyoming Blvd NE
Suite D-4
Albuquerque, NM 87113-2013
Phone
(505) 884-8584
Fax
(505) 821-8594
NPI assigned
Jan 19, 2007
Last updated
Feb 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Dr. Michael Rozenblum, D.C.NPI 1689765406
Title
Business Owner/President
Phone
(505) 884-8584

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 1290 NM Primary

Addresses

Primary practice location

8001 Wyoming Blvd NE
Suite D-4
Albuquerque, NM 87113-2013

Mailing address

8001 Wyoming Blvd NE
Suite D-4
Albuquerque, NM 87113-2013
Phone (505) 884-8584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120301000178 NM Part B Supplier - Clinic/Group Practice 3971761438 Receives reassigned benefits from 4 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

1632 Alameda Blvd NW
Albuquerque, NM 87114
Phone (505) 922-9444

8001 Wyoming Blvd NE
Ste D
Albuquerque, NM 87113
Phone (505) 884-8584

8001 Wyoming Blvd NE
Ste D4
Albuquerque, NM 87113
Phone (505) 884-8584

Practitioners & affiliated clinicians

Practitioners 11

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1669525168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 WYOMING BLVD NE",
            "address_2": "SUITE D-4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132013",
            "telephone_number": "505-884-8584",
            "fax_number": "505-821-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 WYOMING BLVD NE",
            "address_2": "SUITE D-4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132013",
            "telephone_number": "505-884-8584",
            "fax_number": "505-821-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONSTEAD FAMILY CHIROPRACTIC OF ALBUQUERQUE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "ROZENBLUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "BUSINESS OWNER/PRESIDENT",
        "authorized_official_telephone_number": "505-884-8584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.