Organization Active NPI

Graham Chiropractic, PA

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1487841607
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007147 Issued in FL
Legal business name
GRAHAM CHIROPRACTIC, PA
Practice address
7532 W Sand Lake Rd
Orlando, FL 32819-5110
Phone
(407) 363-0052
Fax
(407) 363-0566
NPI assigned
Oct 2, 2007
Last updated
Oct 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Dr. Glenn S Graham, D.C.NPI 1245441708
Title
Presdient
Phone
(407) 363-0052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007147 FL Primary

Addresses

Primary practice location

7532 W Sand Lake Rd
Orlando, FL 32819-5110

Mailing address

7532 W Sand Lake Rd
Orlando, FL 32819-5110
Phone (407) 363-0052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916001279 FL Part B Supplier - Clinic/Group Practice 7618945718 Receives reassigned benefits from 2 practitioners
Practice locations: Cocoa Beach, FL; Orlando, FL

National Provider Directory

National Provider Directory

Locations

5645 N Atlantic Ave
Ste 111
Cocoa Beach, FL 32931
Phone (321) 613-0600

7532 W Sand Lake Rd
Orlando, FL 32819
Phone (407) 363-0052

Practitioners & affiliated clinicians

Practitioners 3

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": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1487841607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7532 W SAND LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195110",
            "telephone_number": "407-363-0052",
            "fax_number": "407-363-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7532 W SAND LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195110",
            "telephone_number": "407-363-0052",
            "fax_number": "407-363-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESDIENT",
        "authorized_official_telephone_number": "407-363-0052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.