Grady Donohoe, DC

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

License

9030 Issued in AZ

Practice address

1914 S Power Rd Ste 107
Mesa, AZ 85206-4376

Phone

(308) 627-5583

NPI assigned

Jan 21, 2019

Last updated

Jul 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1104390343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 S PEACH WILLOW LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852982715",
            "telephone_number": "308-627-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 S POWER RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064376",
            "telephone_number": "308-627-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHOE",
        "first_name": "GRADY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2018045551",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1994",
            "primary": false
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "AZ",
            "license": "9030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrianne Kay Doner, FNP-C
• Eric Dong, D.O.
• James Clark Donley
• Jeffrey Alan Donnelly, RPH
• Deborah C Donofrio, RN
• Brittani Nicole Donovan, RN,BSN
• Donsky Bogle Dermatology LLC (Grand Canyon Dermatology PLLC)
• Ronda Jo Doolen
• Ailis Clare Dooner, MD
• Elizabeth Persis Dormady, M.A.CCC-SLP

• Internist Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internist Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.