Individual provider Active NPI

Dena Delvaron Granger, D.C.

  • Chiropractor
  • Collierville, TN
National Provider Identifier
1750653572
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2675 Issued in TN
Practice address
3615 S Houston Levee Rd
Collierville, TN 38017-9192
Phone
(901) 221-7173
Fax
(901) 221-7934
NPI assigned
Feb 9, 2012
Last updated
Nov 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2675 TN Primary

Addresses

Primary practice location

3615 S Houston Levee Rd
Collierville, TN 38017-9192

Mailing address

76 Tabb Drive
Suite C
Munford, TN 38058
Phone (901) 840-2234

Other practice location 1

76 Tabb Drive
suite C
Munford, TN 38058
Phone (901) 840-2234

Other identifiers 1

IdentifierTypeStateIssuer
Q025029MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151111001382 TN Practitioner - Chiropractic 2860649183 Reassigns benefits to 1 organization
I20210902002926 MS Practitioner - Chiropractic 2860649183

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Chiro Place of Collierville PLLCGroup PAC ID 1951600428, 7 clinicians

Practice addresses (Care Compare)

3615 S Houston Levee Rd
Suite 110
Collierville, TN 38017-9173
Phone 90122171735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2675TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Chiro Place of Collierville PLLC Chiropractor CurrentSince Feb 4, 2016 Accepting new patients
The Chiro Place of Douglasville PC Chiropractor PastSince Jul 28, 2023 Accepting new patients
Chisholm Chiropractic Center P a Past Accepting new patients

Locations

8101 Hacks Cross Rd
Ste 110
Olive Branch, MS 38654

1630 Goodman Rd E
Ste 3
Southaven, MS 38671
Phone (662) 470-7232

2690 Kirby Whitten Rd
Ste 109
Bartlett, TN 38133
Phone (901) 217-7173

3615 S Houston Levee Rd
Ste 110
Collierville, TN 38017
Phone (901) 217-7173

2690 Kirby Whitten Rd
Memphis, TN 38133
Phone (901) 221-7173

3179 Poplar Ave
Memphis, TN 38111
Phone (901) 221-7173

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1750653572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 TABB DRIVE",
            "address_2": "SUITE C",
            "city": "MUNFORD",
            "state": "TN",
            "postal_code": "38058",
            "telephone_number": "901-840-2234",
            "fax_number": "901-840-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 S HOUSTON LEVEE RD",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179192",
            "telephone_number": "901-221-7173",
            "fax_number": "901-221-7934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Tabb Drive",
            "address_2": "suite C",
            "address_purpose": "LOCATION",
            "city": "Munford",
            "state": "TN",
            "postal_code": "38058",
            "country_code": "US",
            "telephone_number": "901-840-2234",
            "fax_number": "901-840-2237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "DENA",
        "middle_name": "DELVARON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q025029",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.