Individual provider Active NPI

Peggy Jean Brown-Grantham, D.C., P.A.

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1447348289
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4540 Issued in KS
Practice address
12631 Antioch Rd
Overland Park, KS 66213-1701
Phone
(913) 685-0022
Fax
(913) 685-9298
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X KS4540 KS
Chiropractor 111N00000X 4540 KS Primary

Addresses

Primary practice location

12631 Antioch Rd
Overland Park, KS 66213-1701

Mailing address

12631 Antioch Rd.
Overland Park, KS 66213-1701
Phone (913) 685-0022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000051 KS Practitioner - Chiropractic 8426198193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12631 Antioch Rd
Overland Park, KS 66213-1701
Phone (913) 685-0022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4540KSMDClinical Social Worker
KS4540KSMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1447348289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 ANTIOCH RD.",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131701",
            "telephone_number": "913-685-0022",
            "fax_number": "913-685-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12631 ANTIOCH RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131701",
            "telephone_number": "913-685-0022",
            "fax_number": "913-685-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-GRANTHAM",
        "first_name": "PEGGY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "D.C., P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "KS4540",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "4540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.