Individual provider Active NPI

Farrel Irvin Grossman, D.C.

  • Sports Physician Chiropractor
  • N Charleston, SC
National Provider Identifier
1336161405
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
1075 Issued in SC
Practice address
283 Dorchester Manor Blvd
N Charleston, SC 29420-8108
Phone
(843) 552-8000
Fax
(843) 552-0093
NPI assigned
Jul 24, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Sports Physician Chiropractor 111NS0005X 1075 SC Primary

Addresses

Primary practice location

283 Dorchester Manor Blvd
N Charleston, SC 29420-8108

Mailing address

283 Dorchester Manor Blvd
N Charleston, SC 29420-8108
Phone (843) 552-8000

Other identifiers 1

IdentifierTypeStateIssuer
GCH299MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000227 SC Practitioner - Chiropractic 2668361981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 Oakbrook Lane
Suite 215
Summerville, SC 29485

201 Oakbrook LN
Suite 215
Summerville, SC 29485-7538
Phone (843) 530-4651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1075SCMDPsychologist
1705SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fig Consulting LLC Sports Physician Current Accepting new patients
Fig Consulting LLC Sports Physician CurrentSince Oct 2, 2020 Accepting new patients
Palmetto Rehab of Charleston LLC Past Accepting new patients

Locations

1903 Savannah Hwy
#A
Charleston, SC 29407
Phone (843) 556-0101

201 Oakbrook Ln
Ste 215
Summerville, SC 29485
Phone (843) 530-4651

Organizations & group practices 3

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336161405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 DORCHESTER MANOR BLVD",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294208108",
            "telephone_number": "843-552-8000",
            "fax_number": "843-552-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 DORCHESTER MANOR BLVD",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294208108",
            "telephone_number": "843-552-8000",
            "fax_number": "843-552-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "FARREL",
        "middle_name": "IRVIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SC",
            "license": "1075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GCH299",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Charleston, SC

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.