Organization Active NPI

Grand Chiropractic

  • Chiropractor
  • Logan TWP, NJ
National Provider Identifier
1023059755
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00623400 Issued in NJ
Legal business name
GRAND CHIROPRACTIC
Practice address
511 Beckett Rd
Logan TWP, NJ 08085-1548
Phone
(856) 467-3377
Fax
(856) 467-3370
NPI assigned
Jun 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Frank Vernon Grandizio Jr., D.C.
Title
Owner
Phone
(856) 467-3377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00623400 NJ Primary

Addresses

Primary practice location

511 Beckett Rd
Logan TWP, NJ 08085-1548

Mailing address

511 Beckett Rd
Logan TWP, NJ 08085-1548
Phone (856) 467-3377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050519000820 NJ Part B Supplier - Clinic/Group Practice 4183665169 Receives reassigned benefits from 1 practitioner
Practice locations: Logan TWP, NJ

National Provider Directory

National Provider Directory

Locations

511 Beckett Rd
Swedesboro, NJ 08085
Phone (856) 241-2844

4515 Pennell Rd
Aston, PA 19014
Phone (610) 497-1928

Practitioners & affiliated clinicians

Practitioners 2

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": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023059755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 BECKETT RD",
            "city": "LOGAN TWP",
            "state": "NJ",
            "postal_code": "080851548",
            "telephone_number": "856-467-3377",
            "fax_number": "856-467-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 BECKETT RD",
            "city": "LOGAN TWP",
            "state": "NJ",
            "postal_code": "080851548",
            "telephone_number": "856-467-3377",
            "fax_number": "856-467-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANDIZIO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-467-3377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00623400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan TWP, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.