NPIMap

Organization Active NPI

Gustav E Schefstrom

Doing business as Rogue Valley Chiropractic Clinic

  • Chiropractor
  • Medford, OR
National Provider Identifier
1790968220
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 1902 Issued in OR
Legal business name
GUSTAV E SCHEFSTROM
Doing business as
Rogue Valley Chiropractic Clinic
Practice address
1744 E McAndrews Rd
Suite a
Medford, OR 97504-5576
Phone
(541) 779-8338
Fax
(541) 858-0749
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

Name
Dr. Gustav E Schefstrom, D.C. B.C.A.O.
Title
Chiropractic Physician
Phone
(541) 779-8338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 27 1902 OR Primary

Addresses

Primary practice location

1744 E McAndrews Rd
Suite a
Medford, OR 97504-5576

Mailing address

1744 E McAndrews Rd
Suite a
Medford, OR 97504-5576
Phone (541) 779-8338

Other identifiers 3

IdentifierTypeStateIssuer
R112380OtherORMEDICARE GRP
R112382OtherORMEDICARE PROVIDER
350008024OtherORRR MEDICARE

Other names 1

  • Rogue Valley Chiropractic Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1619 E Barnett Rd
Medford, OR 97504
Phone (541) 779-8338

1744 E McAndrews Rd
Ste A
Medford, OR 97504
Phone (541) 779-8338

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": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1790968220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 E MCANDREWS RD",
            "address_2": "SUITE A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045576",
            "telephone_number": "541-779-8338",
            "fax_number": "541-858-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 E MCANDREWS RD",
            "address_2": "SUITE A",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045576",
            "telephone_number": "541-779-8338",
            "fax_number": "541-858-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAV E SCHEFSTROM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "SCHEFSTROM",
        "authorized_official_first_name": "GUSTAV",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "541-779-8338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C.  B.C.A.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 1902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "R112380",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "R112382",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350008024",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rogue Valley Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.