Robert W Graham, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3844 Issued in AZ

Practice address

13934 N 59TH Ave
Suite 100
Glendale, AZ 85306-4167

Phone

(602) 298-8400

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Revive Wellness and Rejuvenation LLC

  • Family Nurse Practitioner
  • Glendale, AZ
  • NPI 1184252678
  NPD Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1639299183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13934 N 59TH AVE",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064167",
            "telephone_number": "602-298-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13934 N 59TH AVE",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064167",
            "telephone_number": "602-298-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Meadows Assisted Living LLC
• Ruben Francisco Grace III, LMSW
• Elizabeth Grady, LPC
• Larquietta Grady
• Kendra Graham
• Emma Graner
• John C Graneto, D.M.D.
• Cheryl Ann Granger, NMD
• Carrie Grant
• Gretchen Renee Grant, NBHWC

• Chiropractor in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.