Individual provider Active NPI

Antony L Graham, DC

  • Chiropractor
  • Moscow, PA
National Provider Identifier
1720003254
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008928L Issued in PA
Practice address
1186 Church Street
Moscow, PA 18444
Phone
(570) 842-5131
Fax
(570) 842-5126
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC008928 PA
Chiropractor 111N00000X DC008928L PA Primary
Chiropractor 111N00000X AJ008928L PA

Addresses

Primary practice location

1186 Church Street
Moscow, PA 18444

Mailing address

1186 Church St
Moscow, PA 18444
Phone (570) 842-5131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000426 PA Practitioner - Chiropractic 9638184070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocco Diana DC PCGroup PAC ID 9032519103, 3 clinicians

Practice addresses (Care Compare)

1186 Church St
Moscow, PA 18444-9346
Phone (570) 842-5131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AJ008928LPAMDChiropractor
DC008928LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rocco Diana DC, P.C. Chiropractor CurrentSince Aug 1, 2021 Accepting new patients
Gabriel Chiropractic Center, P.C. Chiropractor Past Accepting new patients
Chiropractic Care Center Chiropractor Past Accepting new patients

Locations

1186 Church St
Moscow, PA 18444
Phone (570) 842-5131

Organizations & group practices 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1720003254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1186 CHURCH ST",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "18444",
            "telephone_number": "570-842-5131",
            "fax_number": "570-842-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 CHURCH STREET",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "18444",
            "telephone_number": "570-842-5131",
            "fax_number": "570-842-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ANTONY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008928",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008928L",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "AJ008928L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.