Individual provider Active NPI

Joshua Gurrola, DC

  • Chiropractor
  • West Bend, WI
National Provider Identifier
1982243358
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5485-12 Issued in WI
Practice address
1201 Oak St Ste O
West Bend, WI 53095-3800
Phone
(262) 346-1936
NPI assigned
Jan 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5485-12 WI Primary

Addresses

Primary practice location

1201 Oak St Ste O
West Bend, WI 53095-3800

Mailing address

1201 Oak St Ste O
West Bend, WI 53095-3800
Phone (262) 346-1936

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503003372 WI Practitioner - Chiropractic 0840630091 Practice locations: West Bend, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1201 Oak St
Suite O
West Bend, WI 53095-3800
Phone (262) 346-1936

1201 Oak St O
West Bend, WI 53095-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5485-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Symmetry Spine Care LLC Chiropractor CurrentSince Dec 8, 2024 Accepting new patients
Mushin PLLC Chiropractor PastSince Jan 1, 2020 Accepting new patients

Locations

1201 Oak St
Ste O
West Bend, WI 53095
Phone (262) 346-1936

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1982243358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 OAK ST STE O",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953800",
            "telephone_number": "262-346-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 OAK ST STE O",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953800",
            "telephone_number": "262-346-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURROLA",
        "first_name": "JOSHUA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5485-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.