Individual provider Active NPI

Robert Grimm, D.C.

  • Chiropractor
  • Saint Joseph, MO
National Provider Identifier
1285676197
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6222 Issued in MO
Practice address
5505 Lake Ave
Saint Joseph, MO 64504-1440
Phone
(816) 238-1200
Fax
(816) 238-4900
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6222 MO Primary

Addresses

Primary practice location

5505 Lake Ave
Saint Joseph, MO 64504-1440

Mailing address

6408 King Hill Ave
Saint Joseph, MO 64504-2068
Phone (816) 238-1200

Other identifiers 1

IdentifierTypeStateIssuer
757656400MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090520000495 MO Practitioner - Chiropractic 2163415738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6408 King Hill Ave
Saint Joseph, MO 64504-2068
Phone (816) 238-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6222MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Grimm Chiropractic PC Chiropractor CurrentSince Aug 23, 2002 Accepting new patients

Locations

5505 Lake Ave
Saint Joseph, MO 64504
Phone (816) 238-1200

6408 King Hill Ave
Saint Joseph, MO 64504
Phone (816) 238-1200

Interoperability endpoints

  • Direct secure messaging: rob@gcp0001.direct.chirotouch.md

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1285676197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6408 KING HILL AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645042068",
            "telephone_number": "816-238-1200",
            "fax_number": "816-238-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 LAKE AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645041440",
            "telephone_number": "816-238-1200",
            "fax_number": "816-238-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "6222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "757656400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.