Individual provider Active NPI

Nathan Edward Grinder, D.C.

  • Chiropractor
  • Chandler, AZ
National Provider Identifier
1164726717
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8174 Issued in AZ
Practice address
2815 E Ocotillo Rd Ste 4
Chandler, AZ 85249-6040
Phone
(480) 781-2964
Fax
(480) 809-4988
NPI assigned
Dec 22, 2010
Last updated
May 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8174 AZ Primary
Sports Physician Chiropractor 111NS0005X 8174 AZ
Rehabilitation Chiropractor 111NR0400X 8174 AZ

Addresses

Primary practice location

2815 E Ocotillo Rd Ste 4
Chandler, AZ 85249-6040

Mailing address

4337 E Amber LN
Gilbert, AZ 85296-1585
Phone (602) 430-4486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000495 AZ Practitioner - Chiropractic 5597949008 Reassigns benefits to 1 organization
Practice locations: Gilbert, AZ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocotillo Medical Group LLCGroup PAC ID 2567748056, 4 clinicians

Practice addresses (Care Compare)

2815 E Ocotillo Rd
Suite 4
Chandler, AZ 85249-6040
Phone (480) 926-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8174AZMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ocotillo Medical Group LLC Chiropractor CurrentSince Mar 30, 2019 Accepting new patients
Ocotillo Health Centers, LLC Chiropractor Past Accepting new patients

Locations

2815 E Ocotillo Rd
Ste 4
Chandler, AZ 85249
Phone (480) 781-2964

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": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1164726717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4337 E AMBER LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961585",
            "telephone_number": "602-430-4486",
            "fax_number": "480-809-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 E OCOTILLO RD STE 4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852496040",
            "telephone_number": "480-781-2964",
            "fax_number": "480-809-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINDER",
        "first_name": "NATHAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-22",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8174",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "AZ",
            "license": "8174",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "8174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.