Individual provider Active NPI

Craig Daniel Gruber, D.C.

  • Chiropractor
  • Kennesaw, GA
National Provider Identifier
1841392735
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005904 Issued in GA
Practice address
3940 Cherokee St NW
Suite 402
Kennesaw, GA 30144-6421
Phone
(770) 423-9010
NPI assigned
Sep 2, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 005904 GA Primary

Addresses

Primary practice location

3940 Cherokee St NW
Suite 402
Kennesaw, GA 30144-6421

Mailing address

3940 Cherokee St NW
Suite 402
Kennesaw, GA 30144-6421
Phone (770) 423-9010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080925000676 GA Practitioner - Chiropractic 0648347062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3940 Cherokee St NW
Suite 402
Kennesaw, GA 30144-6420
Phone (770) 423-9010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Discover Integrated Health, LLC CurrentSince Aug 9, 2017 Accepting new patients

Locations

3940 Cherokee St NW
Ste 402
Kennesaw, GA 30144
Phone (770) 423-9010

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, 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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1841392735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 CHEROKEE ST NW",
            "address_2": "SUITE 402",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446421",
            "telephone_number": "770-423-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 CHEROKEE ST NW",
            "address_2": "SUITE 402",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446421",
            "telephone_number": "770-423-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "CRAIG",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "005904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.