Individual provider Active NPI

Jonathan Jay Grussing, D.C.

  • Chiropractor
  • Clara City, MN
National Provider Identifier
1710022348
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3280 Issued in MN
Practice address
23 North Main Street
Clara City, MN 56222-0793
Phone
(320) 847-3511
Fax
(320) 847-3752
NPI assigned
Feb 21, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3280 MN Primary

Addresses

Primary practice location

23 North Main Street
Clara City, MN 56222-0793

Mailing address

23 North Main Street
P.O. Box 793
Clara City, MN 56222-0793
Phone (320) 847-3511

Other identifiers 2

IdentifierTypeStateIssuer
128M9HEOtherMNBCBS GROUP ID NUMBER
129MOGROtherMNBCBS INDIVIDUAL ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000165 MN Practitioner - Chiropractic 7315901147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23 N Main St
Clara City, MN 56222-1186
Phone (320) 847-3511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3280MNMDOptometrist
53668MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Family Chiropractic, P.a. CurrentSince Aug 29, 2002 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710022348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 NORTH MAIN STREET",
            "address_2": "P.O. BOX 793",
            "city": "CLARA CITY",
            "state": "MN",
            "postal_code": "562220793",
            "telephone_number": "320-847-3511",
            "fax_number": "320-847-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NORTH MAIN STREET",
            "city": "CLARA CITY",
            "state": "MN",
            "postal_code": "562220793",
            "telephone_number": "320-847-3511",
            "fax_number": "320-847-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSSING",
        "first_name": "JONATHAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID NUMBER",
            "identifier": "128M9HE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL ID",
            "identifier": "129MOGR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clara City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.