Chris Grayling, DC
Individual provider Active NPI Chiropractor · Anderson, MO
NPI 1174095665 · NPPES record last updated Jun 21, 2019
Key facts
- NPI
- 1174095665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2004033158 (MO)
- Practice address
- 929-A, Highway 59, Anderson, Mo 64831
Anderson, MO 64831-8203 - Phone
- (417) 226-2225
- NPI assigned
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004033158 | MO | MD | Chiropractor |
| 3606 | CO | MD | Orthopedic Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2004033158 | MO | Yes |
Addresses
Primary practice location
929-A, Highway 59, Anderson, Mo 64831
Anderson, MO 64831-8203
Mailing address
PO Box 5241
Bella Vista, AR 72714-0241
Phone (417) 291-4094
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230064885 | Medicaid | MO |
Other providers in Anderson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.