Individual provider Active NPI

Travis Alan Grondin, D.C.

  • Chiropractor
  • Augusta, ME
National Provider Identifier
1093722670
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR1652 Issued in ME
Practice address
66 Eastern Ave
Augusta, ME 04330-5837
Phone
(207) 620-8291
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR1652 ME Primary

Addresses

Primary practice location

66 Eastern Ave
Augusta, ME 04330-5837

Mailing address

66 Eastern Ave
Augusta, ME 04330-5837
Phone (207) 620-8291

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061116000257 ME Practitioner - Chiropractic 9739187204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital City Chiropractic PCGroup PAC ID 5799784393, 2 clinicians

Practice addresses (Care Compare)

66 Eastern Ave
Augusta, ME 04330-5837
Phone (207) 620-8291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CR1652MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Capital City Chiropractic PC Chiropractor CurrentSince Oct 1, 2006 Accepting new patients

Locations

66 Eastern Ave
Ste 2
Augusta, ME 04330

66 Eastern Ave
Augusta, ME 04330
Phone (207) 620-8291

Organizations & group practices 1

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1093722670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 EASTERN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305837",
            "telephone_number": "207-620-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 EASTERN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305837",
            "telephone_number": "207-620-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONDIN",
        "first_name": "TRAVIS",
        "middle_name": "ALAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.