Individual provider Active NPI

Nathaniel John Gasdorf, DC

  • Chiropractor
  • Angola, IN
National Provider Identifier
1699870436
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0800206A Issued in IN
Practice address
1960 Westwood Dr
Angola, IN 46703-8639
Phone
(260) 665-3533
Fax
(260) 665-3533
NPI assigned
Sep 14, 2006
Last updated
Sep 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0800206A IN Primary

Addresses

Primary practice location

1960 Westwood Dr
Angola, IN 46703-8639

Mailing address

1960 Westwood Dr
Angola, IN 46703-8639
Phone (260) 665-3533

Other identifiers 1

IdentifierTypeStateIssuer
200442340AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000962 IN Practitioner - Chiropractic 5193744704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1960 Westwood Dr
Angola, IN 46703-8639
Phone (260) 665-3533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0800206AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gasdorf Family Chiropractic PC Chiropractor CurrentSince Apr 15, 2003 Accepting new patients

Locations

1960 Westwood Dr
Angola, IN 46703
Phone (260) 665-3533

412 N Wayne St
Angola, IN 46703
Phone (260) 665-3533

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1699870436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 WESTWOOD DR",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038639",
            "telephone_number": "260-665-3533",
            "fax_number": "260-665-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 WESTWOOD DR",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038639",
            "telephone_number": "260-665-3533",
            "fax_number": "260-665-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASDORF",
        "first_name": "NATHANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "0800206A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200442340A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.