Melissa Ann Grill-Petersen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

006115 Issued in GA

Practice address

3281 Shakerley Park
Douglasville, GA 30135-3186

Phone

(678) 213-1046

Fax

(678) 213-1046

NPI assigned

Jul 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1033319900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3281 SHAKERLEY PARK",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301353186",
            "telephone_number": "678-213-1046",
            "fax_number": "678-213-1046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3281 SHAKERLEY PARK",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301353186",
            "telephone_number": "678-213-1046",
            "fax_number": "678-213-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILL-PETERSEN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "006115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.