Jay Melvin Greenberg, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1402 Issued in MN

Practice address

29218 Highway 58 Blvd
Red Wing, MN 55066-7407

Phone

(651) 388-8294

Fax

(651) 388-7461

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Red Wing Chiropractic Wellness P.a.

  • Chiropractor
  • Red Wing, MN
  • NPI 1134351901
  Medicare reassignment NPD

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518060904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29218 HIGHWAY 58 BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550667407",
            "telephone_number": "651-388-8294",
            "fax_number": "651-388-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29218 HIGHWAY 58 BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550667407",
            "telephone_number": "651-388-8294",
            "fax_number": "651-388-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "JAY",
        "middle_name": "MELVIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31174GR",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROCARE",
            "identifier": "230288",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erik R Gram, P.T.
• Grand St Paul CVS LLC
• Jennifer C Granquist-Meacham, DPM
• Great River Therapy Inc
• Madelyn Green
• Seth William Gregory, M.D.
• Anna Patricia Panaligan Grgurovic, LPCC
• Ember June Griebling
• Sydney Griebling
• Sierra Mandela Grote, RN

• Chiropractor in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Chiropractor in Minnesota

• 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.
• 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.