Individual provider Active NPI

Wendy Lynn Gruber, DC

  • Chiropractor
  • Cleveland, TN
National Provider Identifier
1396969143
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000001474 Issued in TN
Practice address
95 Mikel St NW
Cleveland, TN 37312-5332
Phone
(423) 476-0023
Fax
(423) 476-3353
NPI assigned
Apr 12, 2007
Last updated
Dec 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 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 DC0000001474 TN Primary

Addresses

Primary practice location

95 Mikel St NW
Cleveland, TN 37312-5332

Mailing address

95 Mikel St NW
Cleveland, TN 37312-5332
Phone (423) 476-0023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180519000100 TN Practitioner - Chiropractic 6204191307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Wellness Chiropractic CenterGroup PAC ID 2062637135, 2 clinicians

Practice addresses (Care Compare)

95 Mikel St NW
Cleveland, TN 37312-5332
Phone (423) 476-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0000001474TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Wellness Chiropractic Center Chiropractor CurrentSince Oct 30, 2017 Accepting new patients

Locations

95 Mikel St NW
Cleveland, TN 37312
Phone (423) 476-0023

Organizations & group practices 1

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1396969143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MIKEL ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125332",
            "telephone_number": "423-476-0023",
            "fax_number": "423-476-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MIKEL ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125332",
            "telephone_number": "423-476-0023",
            "fax_number": "423-476-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "WENDY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.