Georgia Rosalie Graham, DR OF CHIROPRACTIC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

876 Issued in NM

Practice address

1330 San Pedro NE
Suite 101
Albuquerque, NM 87110

Phone

(505) 265-4697

Fax

(505) 265-0846

NPI assigned

Nov 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336228519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 SAN PEDRO NE",
            "address_2": "#101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-265-4697",
            "fax_number": "505-265-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SAN PEDRO NE",
            "address_2": "SUITE 101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87110",
            "telephone_number": "505-265-4697",
            "fax_number": "505-265-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GEORGIA",
        "middle_name": "ROSALIE",
        "name_prefix": "Dr.",
        "credential": "DR OF CHIROPRACTIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN UNITED",
            "identifier": "663252",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "K486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Patrick Graham
• David Scott Graham, RPH
• Deeana Erica Graham
• Delvina Virginia Graham
• Diana Elaine Graham, RDH, MS
• Glenn D Graham, MD PHD
• James L Graham Jr., FNP
• Jean Ann Graham, RPH
• Jess Graham, M.D.
• John E Graham, MD

• Chiropractor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.