Organization Active NPI

Gregg D. Davis D.C.,P.C.

  • Chiropractor
  • Gold Canyon, AZ
National Provider Identifier
1841546090
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5232 Issued in AZ
Legal business name
GREGG D. DAVIS D.C.,P.C.
Practice address
6268 S Kings Ranch Rd
7-A
Gold Canyon, AZ 85118-7353
Phone
(480) 220-4567
NPI assigned
Jul 25, 2012
Last updated
Jul 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Authorized official

Name
Dr. Gregg D. Davis, D.C.NPI 1508036674
Title
President
Phone
(480) 220-4567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5232 AZ Primary

Addresses

Primary practice location

6268 S Kings Ranch Rd
7-A
Gold Canyon, AZ 85118-7353

Mailing address

6268 S Kings Ranch Rd
7-A
Gold Canyon, AZ 85118-7353
Phone (480) 220-4567

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120921000753 AZ Part B Supplier - Clinic/Group Practice 9032367735 Receives reassigned benefits from 1 practitioner
Practice locations: Gold Canyon, AZ

National Provider Directory

National Provider Directory

Locations

6268 S Kings Ranch Rd
Gold Canyon, AZ 85118

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1841546090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6268 S KINGS RANCH RD",
            "address_2": "7-A",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187353",
            "telephone_number": "480-220-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6268 S KINGS RANCH RD",
            "address_2": "7-A",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187353",
            "telephone_number": "480-220-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGG D. DAVIS D.C.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-220-4567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Canyon, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.