Individual provider Active NPI

David Michael Gustitus, D.C.

  • Chiropractor
  • Vienna, VA
National Provider Identifier
1962458216
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104-557688 Issued in VA
Practice address
8391 Old Courthouse Rd Ste 350
Vienna, VA 22182-3819
Phone
(571) 378-0108
NPI assigned
May 26, 2006
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104-557688 VA Primary

Addresses

Primary practice location

8391 Old Courthouse Rd Ste 350
Vienna, VA 22182-3819

Mailing address

8391 Old Courthouse Rd Ste 350
Vienna, VA 22182-3819
Phone (571) 378-0108

Other identifiers 1

IdentifierTypeStateIssuer
134317710OtherFEDERAL TAX ID

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL wholebodyhealthchiropractic.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230322003042 DC Practitioner - Chiropractic 7315972023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8391 Old Courthouse Rd
Suite 350
Vienna, VA 22182-3819
Phone (414) 839-0983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104-557688VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Body Health LLC Chiropractor CurrentSince Dec 3, 2022 Accepting new patients
Rolc LLC Chiropractor CurrentSince Jun 2, 2022 Accepting new patients
Masche Chiropractic Wellness Center Chiropractor Past Accepting new patients

Locations

8391 Old Courthouse Rd
Ste 350
Vienna, VA 22182
Phone (414) 839-0983

7133 S 76th St
Franklin, WI 53132
Phone (414) 858-1212

Organizations & group practices 3

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1962458216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8391 OLD COURTHOUSE RD STE 350",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823819",
            "telephone_number": "571-378-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8391 OLD COURTHOUSE RD STE 350",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823819",
            "telephone_number": "571-378-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTITUS",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104-557688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "134317710",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wholebodyhealthchiropractic.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8391 Old Courthouse Rd Ste 350",
            "city": "Vienna",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221823819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.