Stanley D Grimmel, D.C.
Individual provider Active NPI Chiropractor · Kenneth City, FL
NPI 1104097427 · NPPES record last updated Nov 5, 2025
Key facts
- NPI
- 1104097427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH9471 (FL)
- Practice address
- 5670 54TH Ave N Ste a-2
Kenneth City, FL 33709-2067 - Phone
- (727) 344-2225
- Fax
- (727) 344-2220
- NPI assigned
- Mar 13, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5670 54TH Ave N
Suite a 2
Kenneth City, FL 33709-2067
Phone (727) 344-2225
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081021000687 | FL | Practitioner - Chiropractic | 6507808078 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH9471 | FL | MD | Chiropractor |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Pete Spinal Care LLC | Current |
Accepting new patients | |
| Dr. Gary W. Smart | Past | Accepting new patients |
Locations
5670 54th Ave N
Ste A-2
Kenneth City, FL 33709
Phone (727) 344-2225
6798 Crosswinds Dr N
Ste C105
St Petersburg, FL 33710
Phone (727) 344-2225
2201 58th St N
St Petersburg, FL 33710
Phone (727) 202-7250
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH9471 | FL | Yes |
Addresses
Primary practice location
5670 54TH Ave N Ste a-2
Kenneth City, FL 33709-2067
Mailing address
5670 54TH Ave N Ste a-2
Kenneth City, FL 33709-2067
Phone (727) 344-2225
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101303800 | Medicaid | FL |
Other providers in Kenneth City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.