Individual provider Active NPI

Christina Marie Graddy, D.C

  • Chiropractor
  • Skiatook, OK
National Provider Identifier
1013185453
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3866 Issued in OK
Practice address
1529 W Rogers Blvd
Skiatook, OK 74070-1085
Phone
(918) 396-4433
Fax
(918) 396-0075
NPI assigned
Feb 19, 2008
Last updated
Jun 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3866 OK Primary

Addresses

Primary practice location

1529 W Rogers Blvd
Skiatook, OK 74070-1085

Mailing address

12410 E 128TH PL N
Collinsville, OK 74021-7182
Phone (918) 396-4433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090420000514 OK Practitioner - Chiropractic 1658428180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4625 S Harvard Ave
Suite 200
Tulsa, OK 74135-2939
Phone (918) 378-9801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3866OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Graddy Chiropractic PLLC Chiropractor CurrentSince Aug 15, 2016 Accepting new patients

Locations

4625 S Harvard Ave
Ste 200
Tulsa, OK 74135
Phone (918) 378-9801

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Organizations & group practices 1

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1013185453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 E 128TH PL N",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740217182",
            "telephone_number": "918-396-4433",
            "fax_number": "918-396-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 W ROGERS BLVD",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740701085",
            "telephone_number": "918-396-4433",
            "fax_number": "918-396-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADDY",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skiatook, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.