Phillip J Gonzales, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30345 Issued in MN

Practice address

8325 City Centre Dr
Woodbury, MN 55125-3605

Phone

(651) 731-0859

Fax

(651) 731-0976

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1720095409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 CITY CENTRE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253605",
            "telephone_number": "651-731-0859",
            "fax_number": "651-731-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "PHILLIP",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "30345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114383200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Frontier Homa Care Inc
• Elizabeth J Goldsmith, MD
• Amy L Golla, COTA/L
• Teresa Jean Gonia
• Kaitlyn Marie Gonzales
• Monia Ensequia Gonzalez
• Yvonne Grace Gonzalez
• Brittany Goodmanson
• Jeanne Mackenzie Goodspeed, MD
• Dillon Goolsby, DDS

• Family Medicine Physician in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.