Individual provider Active NPI

Graciela Carrau-Hernandez, DC

  • Chiropractor
  • Suwanee, GA
National Provider Identifier
1962112490
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO10836 Issued in GA
Practice address
1300 Peachtree Industrial Blvd Ste 3110
Suwanee, GA 30024-4544
Phone
(787) 432-3986
NPI assigned
Nov 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO10836 GA Primary

Addresses

Primary practice location

1300 Peachtree Industrial Blvd Ste 3110
Suwanee, GA 30024-4544

Mailing address

PO Box 392875
Snellville, GA 30039-0048
Phone (787) 432-3986

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230326000152 GA Practitioner - Chiropractic 5092189449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO10836GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifegiving Chiropractic Suwanee LLC Chiropractor CurrentSince Mar 1, 2023 Accepting new patients

Locations

1300 Peachtree Industrial Blvd
Ste 3110
Suwanee, GA 30024
Phone (470) 266-1577

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.

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1962112490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392875",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300390048",
            "telephone_number": "787-432-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 3110",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244544",
            "telephone_number": "787-432-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAU-HERNANDEZ",
        "first_name": "GRACIELA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO10836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.