Individual provider Active NPI

Jason Thad Granger, D.C.

  • Chiropractor
  • Cooper City, FL
National Provider Identifier
1902142334
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10779 Issued in FL
Practice address
5560 S Flamingo Rd
Cooper City, FL 33330-2700
Phone
(954) 533-1977
Fax
(954) 533-1539
NPI assigned
Dec 12, 2012
Last updated
Aug 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 10779 FL Primary

Addresses

Primary practice location

5560 S Flamingo Rd
Cooper City, FL 33330-2700

Mailing address

5560 S Flamingo Rd
Cooper City, FL 33330-2700
Phone (954) 533-1977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141112002104 FL Practitioner - Chiropractic 4981826641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5560 S Flamingo Rd
Cooper City, FL 33330-2700
Phone (954) 533-1977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 10779FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Spinal Care LLC Chiropractor CurrentSince Jun 12, 2015 Accepting new patients
Rolando a. Toulon, DC, PA Chiropractor PastSince Jun 12, 2015 Accepting new patients

Locations

5560 S Flamingo Rd
Cooper City, FL 33330
Phone (954) 533-1977

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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1902142334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 S FLAMINGO RD",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333302700",
            "telephone_number": "954-533-1977",
            "fax_number": "954-533-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 S FLAMINGO RD",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333302700",
            "telephone_number": "954-533-1977",
            "fax_number": "954-533-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "JASON",
        "middle_name": "THAD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-12",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.