Individual provider Active NPI

Eric Anthony Graves, D.C.

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1679668131
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4525 Issued in CO
Practice address
7105 W. 119TH Place
Broomfield, CO 80020
Phone
(303) 635-0211
Fax
(303) 469-9982
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4525 CO Primary

Addresses

Primary practice location

7105 W. 119TH Place
Broomfield, CO 80020

Mailing address

7105 W. 119TH Place
Broomfield, CO 80020
Phone (303) 635-0211

Other identifiers 1

IdentifierTypeStateIssuer
C502578OtherCOMEDICARE GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041129000729 CO Practitioner - Chiropractic 0840189130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4257 Main St
Unit 210
Westminster, CO 80031-5116
Phone (303) 635-0211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4525COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eric a Graves Inc CurrentSince Jun 1, 2003 Accepting new patients

Locations

7105 W 119th Pl
Broomfield, CO 80020
Phone (303) 635-0211

4257 Main St
Unit 210
Westminster, CO 80031
Phone (303) 635-0211

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1679668131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 W. 119TH PLACE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "80020",
            "telephone_number": "303-635-0211",
            "fax_number": "303-469-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 W. 119TH PLACE",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "80020",
            "telephone_number": "303-635-0211",
            "fax_number": "303-469-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ERIC",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C502578",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.