Gravity Spine LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

GRAVITY SPINE LLC

Practice address

209 Elden St Ste 302
Herndon, VA 20170-4847

Phone

(703) 520-9980

Fax

(571) 403-9403

NPI assigned

Mar 24, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kyung Jae Lee, DCNPI 1679921233

Title

Owner/ Chiropractor

Phone

(703) 520-9980

Specialties & licenses 1

Addresses

Other names 1

• Gravity Spine and Wellness Doing business as

Locations

Practitioners 1

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

• Kyung Jae Lee, D.C

  • Chiropractor
  • Herndon, VA
  • NPI 1679921233
  NPD Authorized official

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1265069900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 ELDEN ST STE 302",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704847",
            "telephone_number": "703-520-9980",
            "fax_number": "571-403-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 ELDEN ST STE 302",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704847",
            "telephone_number": "703-520-9980",
            "fax_number": "571-403-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAVITY SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KYUNG",
        "authorized_official_middle_name": "JAE",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "703-520-9980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gravity Spine and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nour Gowharji, BDS,DMD
• Gracewell Inc
• Marcos A Grande, DDS
• Laura Grandy, MSW
• Colin Nicholas Grant, O.D,
• Cameron Gray
• Jennifer Graydon
• Michael Thomas Greelis, PH.D.
• Grace Greenan
• Bryan L Grimmer, D.D.S.

• Chiropractor in Herndon, VA
• Providers in Herndon, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.