Colorado Spine and Sports Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6825 Issued in CO

Legal business name

COLORADO SPINE AND SPORTS CLINIC LLC

Practice address

1189 S Perry St
Ste. 150
Castle Rock, CO 80104-1959

Phone

(303) 241-8827

Fax

(303) 660-6692

NPI assigned

Jul 25, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Matthew James Graham, D.C.NPI 1619235314

Title

Owner

Phone

(303) 688-8855

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 1

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

• Matthew James Graham, D.C.

  • Chiropractor
  • Castle Rock, CO
  • NPI 1619235314
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1346596525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 S PERRY ST",
            "address_2": "STE. 150",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041959",
            "telephone_number": "303-241-8827",
            "fax_number": "303-660-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 S PERRY ST",
            "address_2": "STE. 150",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041959",
            "telephone_number": "303-241-8827",
            "fax_number": "303-660-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO SPINE AND SPORTS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-688-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colorado Pain Practice, LLC
• Colorado Pain Practice, PLLC
• Colorado Permanente Medical Group, P.C.
• Colorado Physio Clinic LLC
• Colorado Podiatry Consultants PC
• Colorado Telerad LLC
• Colorado Therapy and Counseling Services
• Karen K Comba
• Scott A. Comeaux, C.F.A., SA-C
• Comfort Dental Castle Rock LLP

• Chiropractor in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.