Individual provider Active NPI

Jordan Grilliot, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Vandalia, OH
National Provider Identifier
1366979007
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
34.016569 Issued in OH
Practice address
600 Aviator CT Ste 210
Vandalia, OH 45377-9475
Phone
(937) 832-4773
Fax
(937) 832-2986
NPI assigned
May 12, 2017
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 34.016569 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 330890 LA

Addresses

Primary practice location

600 Aviator CT Ste 210
Vandalia, OH 45377-9475

Mailing address

2211 Northbridge TRL
Troy, OH 45373-4667
Phone (937) 626-3110

Other practice location 1

9000 N Main St Ste 227
Englewood, OH 45415-1184
Phone (937) 208-2091

Other practice location 2

875 8th St NE
Massillon, OH 44646-8503
Phone (330) 834-4785

Other practice location 3

1201 S Clearview Pkwy
Jefferson, LA 70121-1015
Phone (504) 736-4800

Other practice location 4

1221 S Clearview Pkwy
New Orleans, LA 70121-1011
Phone (504) 736-4800

Other practice location 5

3130 N County Road 25A Ste 116
Troy, OH 45373-1337
Phone (937) 335-3561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731003879 OH Practitioner - Orthopedic Surgery 3274918321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uvpc Specialists, Inc.Group PAC ID 8921022260, 80 clinicians
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

3130 N Country Rd
25A
Troy, OH 45373-1337
Phone (937) 335-3561

9000 N Main St
Suite 238
Englewood, OH 45415-1184
Phone (937) 208-4200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

Merit-based Incentive Payment System (MIPS)

Final score
87.12 of 100Reported as group
Quality
84.25
Promoting interoperability
100
Improvement activities
40
Cost
72.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)15
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Current Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 4, 2023 Accepting new patients
Uvpc Specialists, Inc. CurrentSince Sep 4, 2023 Accepting new patients
Uvpc Specialists Inc. CurrentSince Sep 4, 2023 Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 4, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

9000 N Main St
Ste 238
Englewood, OH 45415
Phone (937) 832-0006

3170 Kettering Blvd
Bldg 2
Moraine, OH 45439

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3130 N County Road 25A
Ste 116
Troy, OH 45373
Phone (937) 335-3561

3130 N County Road 25A
Ste 212
Troy, OH 45373
Phone (937) 335-0061

3130 N County Road 25A
Uppr Vly
Troy, OH 45373
Phone (937) 335-3561

600 Aviator Ct
Ste 210
Vandalia, OH 45377
Phone (937) 832-4773

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1366979007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 NORTHBRIDGE TRL",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453734667",
            "telephone_number": "937-626-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 AVIATOR CT STE 210",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453779475",
            "telephone_number": "937-832-4773",
            "fax_number": "937-832-2986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St Ste 227",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151184",
            "country_code": "US",
            "telephone_number": "937-208-2091",
            "fax_number": "937-208-4007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 8th St NE",
            "address_purpose": "LOCATION",
            "city": "Massillon",
            "state": "OH",
            "postal_code": "446468503",
            "country_code": "US",
            "telephone_number": "330-834-4785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 S Clearview Pkwy",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "LA",
            "postal_code": "701211015",
            "country_code": "US",
            "telephone_number": "504-736-4800",
            "fax_number": "504-736-4810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 S Clearview Pkwy",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701211011",
            "country_code": "US",
            "telephone_number": "504-736-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 N County Road 25A Ste 116",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453731337",
            "country_code": "US",
            "telephone_number": "937-335-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRILLIOT",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "OH",
            "license": "34.016569",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "LA",
            "license": "330890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.