Individual provider Active NPI

Stuart McLellan Grey, D.C.

  • Chiropractor
  • Brookline, MA
National Provider Identifier
1366585036
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1772 Issued in MA
Practice address
1141 Beacon St Ste C1
Brookline, MA 02446-5507
Phone
(617) 738-7428
Fax
(617) 739-3354
NPI assigned
Feb 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1772 MA Primary

Addresses

Primary practice location

1141 Beacon St Ste C1
Brookline, MA 02446-5507

Mailing address

36 Hampstead Rd
Jamaica Plain, MA 02130-3911
Phone (617) 522-2837

Other identifiers 1

IdentifierTypeStateIssuer
Y36287OtherMAB.C.B.S. OF MA PROVIDER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060424000322 MA Practitioner - Chiropractic 4981614765 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1141 Beacon St
Suite 1
Brookline, MA 02446-5528
Phone (617) 997-3753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1772MAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366585036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HAMPSTEAD RD",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303911",
            "telephone_number": "617-522-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 BEACON ST STE C1",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465507",
            "telephone_number": "617-738-7428",
            "fax_number": "617-739-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "STUART",
        "middle_name": "MCLELLAN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B.C.B.S. OF  MA PROVIDER",
            "identifier": "Y36287",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.