Individual provider Active NPI

G M Gracey, D.C.

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1053532523
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3759 Issued in AZ
Practice address
1530 N Country Club Dr
Suite#18
Mesa, AZ 85201-2551
Phone
(480) 964-4407
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 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 3759 AZ Primary

Addresses

Primary practice location

1530 N Country Club Dr
Suite#18
Mesa, AZ 85201-2551

Mailing address

1530 N Country Club Dr
#18
Mesa, AZ 85201-2560
Phone (480) 964-4407

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121108000613 AZ Practitioner - Chiropractic 0840215174 Practice locations: Mesa, AZ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1530 N Country Club
Suite 18
Mesa, AZ 85201-2560

1530 N Country Club Dr
Mesa, AZ 85201-2560
Phone (480) 964-4407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1053532523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N COUNTRY CLUB DR",
            "address_2": "#18",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012560",
            "telephone_number": "480-964-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N COUNTRY CLUB DR",
            "address_2": "SUITE#18",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012551",
            "telephone_number": "480-964-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACEY",
        "first_name": "G",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.