Organization Active NPI

Palm Beach Physical Medicine

  • Chiropractor
  • West Palm Beach, FL
National Provider Identifier
1609176379
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9392 Issued in FL
Legal business name
PALM BEACH PHYSICAL MEDICINE
Practice address
3111 45TH St Ste 4
West Palm Beach, FL 33407-1981
Phone
(561) 530-4655
NPI assigned
Oct 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Authorized official

Name
Dr. Jonathan Grand, D.C.
Title
President
Phone
(561) 530-4655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9392 FL Primary

Addresses

Primary practice location

3111 45TH St Ste 4
West Palm Beach, FL 33407-1981

Mailing address

PO Box 16836
West Palm Beach, FL 33416-6836
Phone (561) 729-7089

National Provider Directory

National Provider Directory

Locations

3111 45th St
Ste 4
West Palm Beach, FL 33407
Phone (561) 530-4655

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": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1609176379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16836",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334166836",
            "telephone_number": "561-729-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 45TH ST STE 4",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334071981",
            "telephone_number": "561-530-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "GRAND",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-530-4655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.