NPIMap

Organization Active NPI

Grunst Chiropractic Clinic

  • Chiropractor
  • Wadena, MN
National Provider Identifier
1073646121
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2831 Issued in MN
Legal business name
GRUNST CHIROPRACTIC CLINIC
Practice address
10 Bryant Ave SE
Wadena, MN 56482-1544
Phone
(218) 631-3382
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Authorized official

Name
Dr. Jeffrey Alan Grunst, D.C.NPI 1245203751
Title
Owner
Phone
(218) 631-3382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2831 MN Primary

Addresses

Primary practice location

10 Bryant Ave SE
Wadena, MN 56482-1544

Mailing address

10 Bryant Ave SE
Wadena, MN 56482-1544

Other identifiers 1

IdentifierTypeStateIssuer
697665400MedicaidMN

National Provider Directory

National Provider Directory

Locations

10 Bryant Ave SE
Wadena, MN 56482
Phone (218) 631-3382

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1073646121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRYANT AVE SE",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BRYANT AVE SE",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821544",
            "telephone_number": "218-631-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUNST CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "GRUNST",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-631-3382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "697665400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadena, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.