Individual provider Active NPI

Brandon W Grimm, D.C.

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1033146170
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9268 Issued in TX
Practice address
2235 Thousand Oaks Dr Ste 111
San Antonio, TX 78232-3967
Phone
(210) 490-3555
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9268 TX Primary

Addresses

Primary practice location

2235 Thousand Oaks Dr Ste 111
San Antonio, TX 78232-3967

Mailing address

2235 Thousand Oaks Dr Ste 111
San Antonio, TX 78232-3967
Phone (210) 490-3555

Other identifiers 1

IdentifierTypeStateIssuer
8U9450OtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803000242 TX Practitioner - Chiropractic 0143291377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golabs Cbandj Relief PLLCGroup PAC ID 8628423571, 4 clinicians

Practice addresses (Care Compare)

1205 N Loop 1604
Suite 211
San Antonio, TX 78258-4627
Phone (210) 764-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9268TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Golabs CB&J Relief PLLC Chiropractor CurrentSince Jun 7, 2023 Accepting new patients
Dr. Golab'S Chiropractic & Wellness PA Chiropractor CurrentSince Feb 28, 2019 Accepting new patients
E R Chiropractic PC Chiropractor PastSince Nov 15, 1999 Accepting new patients
Dudycha Chiropractic Past Accepting new patients
Brandon Grimm D.C. P.a. Chiropractor PastSince Nov 14, 2005 Accepting new patients

Locations

1205 N Loop 1604 W
Ste 211
San Antonio, TX 78258
Phone (210) 764-8888

1205 N Loop 1604 W
San Antonio, TX 78258
Phone (210) 319-2900

Organizations & group practices 5

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033146170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 THOUSAND OAKS DR STE 111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323967",
            "telephone_number": "210-490-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 THOUSAND OAKS DR STE 111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323967",
            "telephone_number": "210-490-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "BRANDON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8U9450",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.