NPIMap

Organization Active NPI

Degraw Chiropractic Center, Inc

  • Chiropractor
  • South Boston, VA
National Provider Identifier
1093877474
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001991 Issued in VA
Legal business name
DEGRAW CHIROPRACTIC CENTER, INC
Practice address
1993 Hamilton Blvd
Ste a
South Boston, VA 24592-2146
Phone
(434) 575-5130
Fax
(434) 575-7570
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Christopher J Degraw, D.C. C.C.S.P.NPI 1881694800
Title
President
Phone
(434) 575-5130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 0104001991 VA Primary

Addresses

Primary practice location

1993 Hamilton Blvd
Ste a
South Boston, VA 24592-2146

Mailing address

1993 Hamilton Blvd
Suite a
South Boston, VA 24592-2146
Phone (434) 575-5130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105000161 VA Part B Supplier - Clinic/Group Practice 3375737125 Receives reassigned benefits from 3 practitioners
Practice locations: South Boston, VA

National Provider Directory

National Provider Directory

Locations

1993 Hamilton Blvd
Ste A
South Boston, VA 24592
Phone (434) 575-5130

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1093877474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 HAMILTON BLVD",
            "address_2": "SUITE A",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922146",
            "telephone_number": "434-575-5130",
            "fax_number": "434-575-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 HAMILTON BLVD",
            "address_2": "STE A",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922146",
            "telephone_number": "434-575-5130",
            "fax_number": "434-575-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEGRAW CHIROPRACTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "DEGRAW",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-575-5130",
        "authorized_official_credential": "D.C. C.C.S.P."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.