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Dr. Petra Alexandra Sullwold , DC

Chiropractor β€’ Mancos, CO

Active NPI 1063661031 Individual Practitioner Female Practitioner
Practice location in NPPES

245 N Main St
Mancos, CO 813289092

Call 9709038901 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

245 N Main St

Mancos, CO 813289092

Telephone 9709038901

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2008

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Mancos and Colorado

3 active clinicians are listed under Chiropractor with a practice address in Mancos, CO (2,349 in Colorado).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-11-17
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

License # reported to NPPES CA 31018

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Colorado Division of Professions and Occupations.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location November 17, 2020

Registered at 245 N MAIN ST, MANCOS, CO 813289092 (Tel: 9709038901)

πŸ“
Updated Business Mailing Address November 17, 2020

Registered at PO BOX 536, MANCOS, CO 813280536 (Tel: 9709038901)

πŸ‘€
Provider Name / Credentials Updated November 17, 2020

Recorded as PETRA SULLWOLD, DC

βœ…
NPI Profile Active September 15, 2008

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 15, 2008

Registered at 951 INDUSTRIAL RD, SUITE B, SAN CARLOS, CA 940704153 (Tel: 6505934447)

πŸ“
Business Mailing Address (Initial Record) September 15, 2008

Registered at 951 INDUSTRIAL RD, SUITE B, SAN CARLOS, CA 940704153 (Tel: 6505934447)

πŸ‘€
Provider Name / Credentials (Initial Record) September 15, 2008

Recorded as PETRA GILL, DC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 15, 2008

Chiropractor (license number reported to NPPES: CA 31018)

🟒
Initial NPI Registration & Enumeration September 15, 2008

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1063661031
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2008
Last Update: November 17, 2020
Sole Proprietor: Yes

Mailing Address

Po Box 536

Mancos, CO 813280536

Phone: 9709038901

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.