Active NPI
Glover Dwaine Holloway, DC
- Chiropractor
- Denver, CO
National Provider Identifier
1659454502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4241
- Practice address
- 1761 Ogden St
Denver, CO 80218-1017 - Phone
- (303) 861-1774
- Fax
- (303) 861-0606
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4241 | CO | Primary |
Addresses
Primary practice location
1761 Ogden St
Denver, CO 80218-1017
Mailing address
1761 Ogden St
Denver, CO 80218-1017
Phone (303) 861-1774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050808000758 | CO | Practitioner - Chiropractic | 6204865629 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218153600000",
"number": "1659454502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 OGDEN ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802181017",
"telephone_number": "303-861-1774",
"fax_number": "303-861-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1761 OGDEN ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802181017",
"telephone_number": "303-861-1774",
"fax_number": "303-861-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "GLOVER",
"middle_name": "DWAINE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2008-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "4241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.