Individual provider Active NPI

Stanley D Grimmel, D.C.

  • Chiropractor
  • Kenneth City, FL
National Provider Identifier
1104097427
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9471 Issued in 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
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9471 FL Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000687 FL Practitioner - Chiropractic 6507808078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Pete Spinal Care LLC CurrentSince Apr 22, 2008 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

2201 58th St N
St Petersburg, FL 33710
Phone (727) 202-7250

6798 Crosswinds Dr N
Ste C105
St Petersburg, FL 33710
Phone (727) 344-2225

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1104097427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 54TH AVE N STE A-2",
            "city": "KENNETH CITY",
            "state": "FL",
            "postal_code": "337092067",
            "telephone_number": "727-344-2225",
            "fax_number": "727-344-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 54TH AVE N STE A-2",
            "city": "KENNETH CITY",
            "state": "FL",
            "postal_code": "337092067",
            "telephone_number": "727-344-2225",
            "fax_number": "727-344-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMMEL",
        "first_name": "STANLEY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenneth City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.