Individual provider Active NPI

Gary Lee Draper, DC

  • Chiropractor
  • Cornelius, NC
National Provider Identifier
1265708028
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4263 Issued in NC
Practice address
19824 W Catawba Ave Ste E
Cornelius, NC 28031
Phone
(704) 987-5050
Fax
(704) 987-5067
NPI assigned
Mar 27, 2012
Reactivated
May 26, 2023
Last updated
May 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4263 NC Primary

Addresses

Primary practice location

19824 W Catawba Ave Ste E
Cornelius, NC 28031

Mailing address

19824 W Catawba Ave Ste E
Cornelius, NC 28031-4046
Phone (704) 987-5050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000359 NC Practitioner - Chiropractic 9133382005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18805 W Catawba Ave
Suite 101
Cornelius, NC 28031-4609
Phone (704) 987-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Optometry Center, PA PastSince Feb 17, 2010 Accepting new patients
Hicks Chiropractic, P.a. Past Accepting new patients
Healthsource of Cary, PLLC Chiropractor Past Accepting new patients
Lake Norman Health and Wellness, PA Chiropractor Past Accepting new patients

Organizations & group practices 5

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": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1265708028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19824 W CATAWBA AVE STE E",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314046",
            "telephone_number": "704-987-5050",
            "fax_number": "704-987-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19824 W CATAWBA AVE STE E",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "28031",
            "telephone_number": "704-987-5050",
            "fax_number": "704-987-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAPER",
        "first_name": "GARY",
        "middle_name": "LEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "deactivation_date": "2023-02-22",
        "reactivation_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.