Organization Active NPI

GC Grover BS DC PC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1306850953
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3782 Issued in AZ
Legal business name
GC GROVER BS DC PC
Practice address
15420 North 7TH St
Suite B
Phoenix, AZ 85022
Phone
(602) 298-0292
Fax
(602) 298-6961
NPI assigned
Jul 28, 2006
Last updated
Jul 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Gary Grover
Title
President
Phone
(602) 298-0292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3782 AZ Primary

Addresses

Primary practice location

15420 North 7TH St
Suite B
Phoenix, AZ 85022

Mailing address

15420 North 7TH St
Suite B
Phoenix, AZ 85022
Phone (602) 298-0292

Other identifiers 1

IdentifierTypeStateIssuer
AZ0249810OtherAZBCBS OF AZ PROVIDER #

Other names 1

  • Moon Valley Chiropractic Other name

National Provider Directory

National Provider Directory

Locations

15420 N 7th St
Ste B
Phoenix, AZ 85022
Phone (602) 298-0292

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1306850953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 NORTH 7TH ST",
            "address_2": "SUITE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85022",
            "telephone_number": "602-298-0292",
            "fax_number": "602-298-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 NORTH 7TH ST",
            "address_2": "SUITE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85022",
            "telephone_number": "602-298-0292",
            "fax_number": "602-298-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GC GROVER BS DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "GROVER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-298-0292"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AZ PROVIDER #",
            "identifier": "AZ0249810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moon Valley Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.