Organization Active NPI

Griz Chiropractic LLC

  • Chiropractor
  • Jackson, MI
National Provider Identifier
1396582169
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GRIZ CHIROPRACTIC LLC
Practice address
2522 Lansing Ave
Jackson, MI 49202-1647
Phone
(517) 395-0837
NPI assigned
Jul 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Dr. John Trevor Griswold, DCNPI 1720706062
Title
Owner/ Chiropractor
Phone
(517) 395-0837

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 Primary

Addresses

Primary practice location

2522 Lansing Ave
Jackson, MI 49202-1647

Mailing address

5995 Lansing Ave
Jackson, MI 49201-8104
Phone (517) 395-0837

Other identifiers 1

IdentifierTypeStateIssuer
1720706062MedicaidMI

Other names 1

  • Griz Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905002657 MI Part B Supplier - Clinic/Group Practice 2062952013 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Locations

2522 Lansing Ave
Jackson, MI 49202
Phone (517) 395-0837

Practitioners & affiliated clinicians

Practitioners 1

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": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1396582169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018104",
            "telephone_number": "517-395-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021647",
            "telephone_number": "517-395-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIZ CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "GRISWOLD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "517-395-0837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720706062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Griz Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.