Individual provider Active NPI

Tiffany Lynn Graham, D.C.

  • Chiropractor
  • Colorado Springs, CO
National Provider Identifier
1578859997
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0006927 Issued in CO
Practice address
1465 Kelly Johnson Blvd Ste 110
Colorado Springs, CO 80920-3945
Phone
(719) 445-6077
Fax
(719) 323-6242
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0006927 CO Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd Ste 110
Colorado Springs, CO 80920-3945

Mailing address

1465 Kelly Johnson Blvd Ste 110
Colorado Springs, CO 80920-3945
Phone (719) 445-6077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130819000689 CO Practitioner - Chiropractic 1254573355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Health IncGroup PAC ID 9830625557, 2 clinicians

Practice addresses (Care Compare)

5191 S Yosemite St
Suite B
Greenwood Village, CO 80111-3360
Phone (303) 577-9977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0006927COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Health Inc Chiropractor CurrentSince Oct 11, 2024 Accepting new patients

Locations

5191 S Yosemite St
Ste B
Greenwood Village, CO 80111
Phone (303) 399-3315

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1578859997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-445-6077",
            "fax_number": "719-323-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-445-6077",
            "fax_number": "719-323-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "0006927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.