Kevin K Gruhot, D.C., D.A.B.C.O., C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

516 Issued in ND

Practice address

2840 19TH Ave S
Grand Forks, ND 58201-5957

Phone

(701) 772-2670

Fax

(701) 772-2706

NPI assigned

Jul 5, 2005

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 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1679570758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-772-2670",
            "fax_number": "701-772-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-772-2670",
            "fax_number": "701-772-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUHOT",
        "first_name": "KEVIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C., D.A.B.C.O., C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16663",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "N70688",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS CLINIC NUMBER",
            "identifier": "675-001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1003950023",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1679570758",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-PIN",
            "identifier": "N10810",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ND PROVIDER NUMBER",
            "identifier": "010810",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.