Organization Active NPI

Grant Family Chiropractic, LLC

  • Chiropractor
  • Noblesville, IN
National Provider Identifier
1295805208
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002113A Issued in IN
Legal business name
GRANT FAMILY CHIROPRACTIC, LLC
Practice address
585 Sheridan Rd
Noblesville, IN 46060-1317
Phone
(317) 219-0354
Fax
(317) 219-3083
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Authorized official

Name
Dr. Pamela Jo Grant, D.C.NPI 1598859605
Title
Owner
Phone
(317) 219-0354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08002113A IN Primary

Addresses

Primary practice location

585 Sheridan Rd
Noblesville, IN 46060-1317

Mailing address

585 Sheridan Rd
Noblesville, IN 46060-1317
Phone (317) 219-0354

Other identifiers 3

IdentifierTypeStateIssuer
703858OtherUNITED HEALTH CARE
000000504008OtherINBLUE CROSS BLUE SHIELD
200838160AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070328000440 IN Part B Supplier - Clinic/Group Practice 5698879815 Receives reassigned benefits from 1 practitioner
Practice locations: Noblesville, IN

National Provider Directory

National Provider Directory

Locations

175 Sheridan Rd
#12
Noblesville, IN 46060
Phone (317) 529-8605

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1295805208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SHERIDAN RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460601317",
            "telephone_number": "317-219-0354",
            "fax_number": "317-219-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SHERIDAN RD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460601317",
            "telephone_number": "317-219-0354",
            "fax_number": "317-219-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-219-0354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002113A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "703858",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000504008",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200838160A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.

Verify at the official NPI Registry.