Active NPI
Ian Grunberg, D.C.
- Chiropractor
- Saint Paul, MN
National Provider Identifier
1710039847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1485
- Practice address
- 1386 7TH St W
Saint Paul, MN 55102-4206 - Phone
- (651) 293-9200
- Fax
- (651) 228-7103
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1485 | MN | Primary |
Addresses
Primary practice location
1386 7TH St W
Saint Paul, MN 55102-4206
Mailing address
1386 7TH St W
Saint Paul, MN 55102-4206
Phone (651) 293-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1D238GR | Other | MN | BCBSM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1485 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1710039847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1386 7TH ST W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551024206",
"telephone_number": "651-293-9200",
"fax_number": "651-228-7103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1386 7TH ST W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551024206",
"telephone_number": "651-293-9200",
"fax_number": "651-228-7103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNBERG",
"first_name": "IAN",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-17",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1485",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "1D238GR",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.