Organization Active NPI

Dr. Gary Draper DC PLLC

  • Clinic/Center
  • Cornelius, NC
National Provider Identifier
1629541255
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DR. GARY DRAPER DC PLLC
Practice address
18805 W Catawba Ave Ste 101
Cornelius, NC 28031-4609
Phone
(704) 987-5050
Fax
(704) 987-5067
NPI assigned
Jan 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Authorized official

Name
Dr. Gary Lee Draper, DCNPI 1265708028
Title
Chiropractor
Phone
(704) 987-5050

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

18805 W Catawba Ave Ste 101
Cornelius, NC 28031-4609

Mailing address

18805 W Catawba Ave Ste 101
Cornelius, NC 28031-4609
Phone (704) 987-5050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190108002085 NC Part B Supplier - Clinic/Group Practice 2961748207 Receives reassigned benefits from 1 practitioner
Practice locations: Cornelius, NC

National Provider Directory

National Provider Directory

Locations

18805 W Catawba Ave
Ste 101
Cornelius, NC 28031
Phone (704) 987-5050

19824 W Catawba Ave
Ste E
Cornelius, NC 28031
Phone (704) 655-8930

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1629541255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 101",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314609",
            "telephone_number": "704-987-5050",
            "fax_number": "704-987-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18805 W CATAWBA AVE STE 101",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314609",
            "telephone_number": "704-987-5050",
            "fax_number": "704-987-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GARY DRAPER DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-07",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "DRAPER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "704-987-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.