Individual provider Active NPI

Edward A Traum, D.C.

  • Chiropractor
  • Tempe, AZ
National Provider Identifier
1184762593
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5820 Issued in AZ
Practice address
2135 E Southern Ave
Tempe, AZ 85282-7503
Phone
(480) 456-3703
Fax
(480) 456-0477
NPI assigned
Feb 1, 2007
Last updated
Nov 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5820 AZ Primary
Rehabilitation Chiropractor 111NR0400X 3441 AZ

Addresses

Primary practice location

2135 E Southern Ave
Tempe, AZ 85282-7503

Mailing address

2135 E Southern Ave
Tempe, AZ 85282-7503
Phone (480) 456-3703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160513000682 AZ Practitioner - Chiropractic 8628367968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1997
Medicare assignment
May accept Medicare assignment
Group practices
3D Integrated Medical LLCGroup PAC ID 3072860808, 2 clinicians

Practice addresses (Care Compare)

2135 E Southern Ave
Tempe, AZ 85282-7503
Phone (480) 456-3703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5820AZMDChiropractor
3441AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
3D Integrated Medical, LLC Chiropractor CurrentSince Jul 9, 2018 Accepting new patients

Locations

2135 E Southern Ave
Tempe, AZ 85282
Phone (480) 221-9314

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1184762593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827503",
            "telephone_number": "480-456-3703",
            "fax_number": "480-456-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827503",
            "telephone_number": "480-456-3703",
            "fax_number": "480-456-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUM",
        "first_name": "EDWARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5820",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "3441",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.