Active NPI
Patrick Robert Gottfried, DC
- Chiropractor
- Newburgh, IN
National Provider Identifier
1871609917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038007937
- Practice address
- 8887 High Pointe Dr
Suite F
Newburgh, IN 47630-7969 - Phone
- (812) 490-7386
- Fax
- (812) 490-7386
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038007937 | IL | Primary |
| Chiropractor | 111N00000X | 08002502A | IN |
Addresses
Primary practice location
8887 High Pointe Dr
Suite F
Newburgh, IN 47630-7969
Mailing address
5844 Cypress Pointe Dr
Newburgh, IN 47630-9843
Phone (812) 480-5835
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331358 | Other | IL | HEALTHLINK |
| 08021310 | Other | IL | BCBS OF IL |
| 038007937 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002502A | IN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chirorevolution | Chiropractor | Past | Accepting new patients |
| Feddes Chiropractic LTD | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Newburgh, IN
- NPI 1285078428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1871609917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5844 CYPRESS POINTE DR",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476309843",
"telephone_number": "812-480-5835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8887 HIGH POINTE DR",
"address_2": "SUITE F",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476307969",
"telephone_number": "812-490-7386",
"fax_number": "812-490-7386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTFRIED",
"first_name": "PATRICK",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038007937",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08002502A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "331358",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IL",
"identifier": "08021310",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038007937",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.