Kelley Boulevard Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

983 Issued in MA

Legal business name

KELLEY BOULEVARD CHIROPRACTIC

Practice address

72 Taunton St Ste G01
Plainville, MA 02762-2132

Phone

(508) 699-2228

Fax

(508) 699-2228

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Martin I Gruder, D.C.

Title

Chiropractor/Owner

Phone

(508) 699-2228

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1083895221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 TAUNTON ST STE G01",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027622132",
            "telephone_number": "508-699-2228",
            "fax_number": "508-699-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 TAUNTON ST STE G01",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027622132",
            "telephone_number": "508-699-2228",
            "fax_number": "508-699-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY BOULEVARD CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "GRUDER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "508-699-2228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Plainville, MA
• Providers in Plainville, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.