Individual provider Active NPI

Adam Gregory Traylor, D.C.

  • Chiropractor
  • Montgomery, IN
National Provider Identifier
1033389762
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002380A Issued in IN
Practice address
439 N Main St
Montgomery, IN 47558-4501
Phone
(812) 486-2577
NPI assigned
Mar 10, 2008
Last updated
Mar 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002380A IN Primary

Addresses

Primary practice location

439 N Main St
Montgomery, IN 47558-4501

Mailing address

PO Box 264
Montgomery, IN 47558-0264
Phone (812) 486-2577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000711 IN Practitioner - Chiropractic 0345311445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

439 N Main St
Suite 1
Montgomery, IN 47558-4527
Phone (812) 486-2577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002380AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Traylor Chiropractic LLC Chiropractor CurrentSince Apr 14, 2008 Accepting new patients

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1033389762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "MONTGOMERY",
            "state": "IN",
            "postal_code": "475580264",
            "telephone_number": "812-486-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 N MAIN ST",
            "city": "MONTGOMERY",
            "state": "IN",
            "postal_code": "475584501",
            "telephone_number": "812-486-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYLOR",
        "first_name": "ADAM",
        "middle_name": "GREGORY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002380A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.