Individual provider Active NPI

Kevin King Granger, D.C.

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1780769760
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1140 Issued in OH
Practice address
2288 Drew St
Suite E
Clearwater, FL 33765-3307
Phone
(727) 248-0930
Fax
(866) 245-2270
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1140 OH Primary

Addresses

Primary practice location

2288 Drew St
Suite E
Clearwater, FL 33765-3307

Mailing address

80 Rogers St
Unit 8 D
Clearwater, FL 33756-5296
Phone (727) 248-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1140OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Chiropractic and Family Medicine, Inc. Chiropractor Past Accepting new patients
King Diagnostic LLC Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1780769760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ROGERS ST",
            "address_2": "UNIT 8 D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565296",
            "telephone_number": "727-248-0930",
            "fax_number": "866-245-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 DREW ST",
            "address_2": "SUITE E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653307",
            "telephone_number": "727-248-0930",
            "fax_number": "866-245-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "KEVIN",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.