Individual provider Active NPI

Gerald Kevin Gifford, D.C.

  • Neurology Chiropractor
  • Mesa, AZ
National Provider Identifier
1891752382
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
4996 Issued in AZ
Practice address
2716 E Hopi Avenue
Mesa, AZ 85204-6266
Phone
(480) 813-2906
Fax
(480) 813-2916
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4996 AZ
Neurology Chiropractor 111NN0400X 4996 AZ Primary

Addresses

Primary practice location

2716 E Hopi Avenue
Mesa, AZ 85204-6266

Mailing address

2716 E Hopi Ave
Mesa, AZ 85204-6266
Phone (480) 813-2906

Other identifiers 1

IdentifierTypeStateIssuer
498502MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000173 AZ Practitioner - ChiropracticPractitioner - Neurology 4486670379 Practice locations: Mesa, AZ

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Neurology
Education
Los Angeles College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

65 E 1St Ave
Suite 101
Mesa, AZ 85210-1456
Phone (480) 813-2906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4996AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gifford Health Institute Corp Neurology PastSince Jul 1, 2008 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, 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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1891752382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 E HOPI AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046266",
            "telephone_number": "480-813-2906",
            "fax_number": "480-813-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 E HOPI AVENUE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046266",
            "telephone_number": "480-813-2906",
            "fax_number": "480-813-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "GERALD",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4996",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "AZ",
            "license": "4996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498502",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.