Individual provider Active NPI

Anthony Wayne Grant, D.C.

  • Chiropractor
  • Columbia, KY
National Provider Identifier
1013003631
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4303 Issued in KY
Practice address
908 Russell Road
Columbia, KY 42728
Phone
(270) 384-3270
Fax
(270) 384-3271
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4303 KY Primary

Addresses

Primary practice location

908 Russell Road
Columbia, KY 42728

Mailing address

908 Russell Road
Columbia, KY 42728
Phone (270) 384-3270

Other identifiers 2

IdentifierTypeStateIssuer
000000330968OtherKYBLUE CROSS PIN
85900413MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000633 KY Practitioner - Chiropractic 6204824980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

908 Russel Rd
Columbia, KY 42728-1036
Phone (270) 384-3271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4303KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Chiropractic Center, Inc CurrentSince Mar 1, 2004 Accepting new patients

Locations

908 Russell Rd
Columbia, KY 42728
Phone (270) 384-3270

Networks

  • OH PPO
  • TN PPO C-SNP
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • KY PPO
  • TN PPO
  • KY PPO C-SNP

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1013003631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 RUSSELL ROAD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "42728",
            "telephone_number": "270-384-3270",
            "fax_number": "270-384-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 RUSSELL ROAD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "42728",
            "telephone_number": "270-384-3270",
            "fax_number": "270-384-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ANTHONY",
        "middle_name": "WAYNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "000000330968",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85900413",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.