Active NPI
Gordon J Grobelny, D.C.
- Chiropractor
- Yelm, WA
National Provider Identifier
1508904293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Practice address
- 10501 Creek St SE Ste 2
Yelm, WA 98597 - Phone
- (360) 458-8258
- NPI assigned
- Feb 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | WA | Primary |
Addresses
Primary practice location
10501 Creek St SE Ste 2
Yelm, WA 98597
Mailing address
PO Box 1936
Yelm, WA 98597-1936
Phone (360) 458-8258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 602244803 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508904293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1936",
"city": "YELM",
"state": "WA",
"postal_code": "985971936",
"telephone_number": "360-458-8258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10501 CREEK ST SE STE 2",
"city": "YELM",
"state": "WA",
"postal_code": "98597",
"telephone_number": "360-458-8258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROBELNY",
"first_name": "GORDON",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yelm, WA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.