Individual provider Active NPI

Amy Lynn Grabowski, D.C.

  • Chiropractor
  • Brentwood, MO
National Provider Identifier
1316185960
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011659 Issued in NY
Practice address
2230 S Brentwood Blvd
Brentwood, MO 63144-1831
Phone
(314) 678-9355
NPI assigned
Feb 4, 2009
Last updated
Jan 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 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 X011659 NY Primary

Addresses

Primary practice location

2230 S Brentwood Blvd
Brentwood, MO 63144-1831

Mailing address

2274 Niagara Falls Blvd
Tonawanda, NY 14150-4735
Phone (716) 693-6058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120206000832 MO Practitioner - Chiropractic 0446308613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidan Family Chiropractic Clinic, LLCGroup PAC ID 4880795657, 2 clinicians

Practice addresses (Care Compare)

2230 S Brentwood Blvd
Brentwood, MO 63144-1831
Phone (314) 678-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X011659NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vidan Family Chiropractic Clinic, LLC Chiropractor CurrentSince Jul 16, 2018 Accepting new patients
Nova Medical Center, LLC PastSince Nov 3, 2019 Accepting new patients

Locations

2230 S Brentwood Blvd
Saint Louis, MO 63144
Phone (314) 678-9355

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1316185960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2274 NIAGARA FALLS BLVD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141504735",
            "telephone_number": "716-693-6058",
            "fax_number": "716-693-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 S BRENTWOOD BLVD",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631441831",
            "telephone_number": "314-678-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABOWSKI",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.