Gregory Thomas Smock, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1471 Issued in MN

Practice address

29 Lake St S
Big Lake, MN 55309-4588

Phone

(763) 263-3470

Fax

(763) 263-5900

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Smock Chiropractic LLC

  • Chiropractor
  • Buffalo, MN
  • NPI 1265744742
  NPD (past) Authorized official
• Integrated Care Clinics, PA

  • Physical Therapist
  • Monticello, MN
  • NPI 1396775110
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1639264757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553090277",
            "telephone_number": "763-263-3470",
            "fax_number": "763-263-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 LAKE ST S",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094588",
            "telephone_number": "763-263-3470",
            "fax_number": "763-263-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOCK",
        "first_name": "GREGORY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Schlueter, MSW, LICSW
• Kathryn Sara Schurman, P.T.
• Amanda Seefeldt
• Gloria Simonson
• Christopher James Slice
• Southern General Contracting
• Timothy John Stephens
• Nicole Rae Straw, MA OTR,L
• Barbro E Strom Langley
• Lola B Sutherland, MD

• Chiropractor in Big Lake, MN
• Providers in Big Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.