Individual provider Active NPI

Stanley Jason Graczyk, D.C.

  • Chiropractor
  • Durham, NC
National Provider Identifier
1285865014
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3988 Issued in NC
Practice address
5310 NC Highway 55
Suite 102
Durham, NC 27713-7813
Phone
(919) 544-4663
Fax
(919) 544-6427
NPI assigned
Jul 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3988 NC Primary

Addresses

Primary practice location

5310 NC Highway 55
Suite 102
Durham, NC 27713-7813

Mailing address

5310 NC Highway 55
Suite 102
Durham, NC 27713-7813
Phone (919) 544-4663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100112000724 NC Practitioner - Chiropractic 2264573294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triangle Chiropractic PCGroup PAC ID 6305987322, 4 clinicians

Practice addresses (Care Compare)

5107 NC Hwy 55
Suite 103
Durham, NC 27713-9685
Phone (919) 544-4663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3988NCMDMental Health Counselor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1285865014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 NC HIGHWAY 55",
            "address_2": "SUITE 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137813",
            "telephone_number": "919-544-4663",
            "fax_number": "919-544-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 NC HIGHWAY 55",
            "address_2": "SUITE 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137813",
            "telephone_number": "919-544-4663",
            "fax_number": "919-544-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACZYK",
        "first_name": "STANLEY",
        "middle_name": "JASON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.