Individual provider Active NPI

Jamie Grainger, D.C.

  • Chiropractor
  • Debary, FL
National Provider Identifier
1194259226
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 12148 Issued in FL
Practice address
70 Fox Ridge CT Ste a
Debary, FL 32713-2752
Phone
(386) 668-6321
NPI assigned
Apr 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 12148 FL Primary

Addresses

Primary practice location

70 Fox Ridge CT Ste a
Debary, FL 32713-2752

Mailing address

58 N Charles Richard Beall Blvd Ste B
Debary, FL 32713-2507
Phone (386) 668-6321

Other practice location 1

587 Majestic Oak Dr
Apopka, FL 32712-4083
Phone (321) 804-1897

Other practice location 2

58 N Charles Richard Beall Blvd Ste B
Debary, FL 32713-2507
Phone (386) 668-6321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address doc@ultimatespine.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006001973 FL Practitioner - Chiropractic 7911272588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70 Fox Ridge CT
Suite a
Debary, FL 32713-2752
Phone (386) 668-6321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 12148FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Debary Chiropractic Center Corp Chiropractor CurrentSince Jul 25, 2017 Accepting new patients
Ultimate Medical Clinic LLC CurrentSince Feb 25, 2021 Accepting new patients

Locations

58 N US Highway 17 92
Ste B
Debary, FL 32713
Phone (386) 668-6321

70 Fox Ridge Ct
Ste A
Debary, FL 32713
Phone (386) 668-4411

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": "1492214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194259226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 N CHARLES RICHARD BEALL BLVD STE B",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132507",
            "telephone_number": "386-668-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 FOX RIDGE CT STE A",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132752",
            "telephone_number": "386-668-6321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "587 Majestic Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Apopka",
            "state": "FL",
            "postal_code": "327124083",
            "country_code": "US",
            "telephone_number": "321-804-1897",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 N Charles Richard Beall Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Debary",
            "state": "FL",
            "postal_code": "327132507",
            "country_code": "US",
            "telephone_number": "386-668-6321",
            "fax_number": "386-668-6321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAINGER",
        "first_name": "JAMIE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-15",
        "last_updated": "2022-07-21",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 12148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "doc@ultimatespine.com",
            "affiliation": "N",
            "endpointDescription": "Gmail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "70 Fox Ridge Ct Ste A",
            "city": "Debary",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327132752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Debary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.