Active NPI
John Graham, D.C.
- Chiropractor
- Clifton Park, NY
National Provider Identifier
1790893048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X2183
- Practice address
- 21 Executive Park Dr
Clifton Park, NY 12065-8651 - Phone
- (518) 371-5422
- Fax
- (518) 371-2063
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 | X2183 | NY | Primary |
Addresses
Primary practice location
21 Executive Park Dr
Clifton Park, NY 12065-8651
Mailing address
21 Executive Park Dr
Clifton Park, NY 12065-8651
Phone (518) 371-5422
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X3A141 | Other | NY | EMPIRE BC/BS |
| 10035363 | Other | NY | CDPHP |
| 98L1853 | Other | NY | MVP |
| C02183-4 | Other | NY | WORKER COMPENSATION |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X2183 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Graham DC PC | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Clifton Park, NY
- NPI 1255510616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1790893048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 EXECUTIVE PARK DR",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120658651",
"telephone_number": "518-371-5422",
"fax_number": "518-371-2063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 EXECUTIVE PARK DR",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120658651",
"telephone_number": "518-371-5422",
"fax_number": "518-371-2063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X2183",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "X3A141",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10035363",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "98L1853",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKER COMPENSATION",
"identifier": "C02183-4",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.