Active NPI
Gary L Grossman, D.C.
- Chiropractor
- Southfield, MI
National Provider Identifier
1144393307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301007140
- Practice address
- 17336 W 12 Mile Rd Ste 106
Southfield, MI 48076-2113 - Phone
- (248) 395-0800
- NPI assigned
- Nov 16, 2006
- Last updated
- Feb 4, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301007140 | MI | Primary |
Addresses
Primary practice location
17336 W 12 Mile Rd Ste 106
Southfield, MI 48076-2113
Mailing address
17336 W 12 Mile Rd Ste 106
Southfield, MI 48076-2113
Phone (248) 395-0080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080520000541 | MI | Practitioner - Chiropractic | 1759450562 | Practice locations: Southfield, MI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Center of Oak Park LLC | Chiropractor | Past | Accepting new patients |
| Fireberg Chiropractic Center | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Oak Park, MI
- NPI 1861746646
-
- Chiropractor
- Hazel Park, MI
- NPI 1639347602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1144393307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17336 W 12 MILE RD STE 106",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762113",
"telephone_number": "248-395-0080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17336 W 12 MILE RD STE 106",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762113",
"telephone_number": "248-395-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2021-02-04",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301007140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.