Grant Speer

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13527 Issued in FL

Practice address

956 Rustlewood LN
Saint Johns, FL 32259-5950

Phone

(217) 273-2098

NPI assigned

Jun 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back to Health Physician'S Group, LTD.Group PAC ID 9335137611, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Back to Health Physicians Group LTD

  • Chiropractor
  • Charleston, IL
  • NPI 1083736169
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1659948917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 DURBIN STATION CT",
            "address_2": "SUITE 802",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "32259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 RUSTLEWOOD LN",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322595950",
            "telephone_number": "217-273-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEER",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "13527",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grant@stjchiro.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "address_1": "185 Durbin Station Ct",
            "address_2": "Suite 802",
            "city": "Saint Johns",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Southeast Orthopedic Specialists, LLC
• Southeast Orthopedic Specialists, LLC
• Spame
• Connor Spangenberg
• Speech With Nicole LLC
• Sydney Spera
• SRS Medical LLC
• St Johns Chiropractic, PLLC
• St Vincent'S Full Service Urgent Care, LLC
• St Vincents Health System Inc

• All providers in Saint Johns, FL
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.