John Thomas Gottschalk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2902 Issued in TN

Practice address

650 Joel Dr
Fort Campbell, KY 42223

Phone

(270) 412-0742

NPI assigned

Dec 31, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1801032461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 BRIGG DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370437998",
            "telephone_number": "214-680-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-412-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTSCHALK",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-31",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2234",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA2902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Gordon, APN
• Timothy Gordon
• Jeremy Mac Gorman, MOTR
• Jesse Gossett, RN
• William Joseph Gottlick, AUD
• Georgina Gould, LCSW
• Christopher Grace, DO
• Leonard Grado, M.D.
• Jacqueline Graf, RD
• Kristine Graham, PHARMD

• Physician Assistant in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.