Individual provider Active NPI

Steven Wayne Grimm, D.C.

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1720155526
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC6997 Issued in TX
Practice address
7330 San Pedro Ave
Suite 120
San Antonio, TX 78216
Phone
(210) 342-4000
Fax
(210) 342-4181
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 6997 TX
Chiropractor 111N00000X DC6997 TX Primary

Addresses

Primary practice location

7330 San Pedro Ave
Suite 120
San Antonio, TX 78216

Mailing address

21115 N Hwy 281
Ste 1502
San Antonio, TX 78258-7634
Phone (210) 342-4000

Other identifiers 2

IdentifierTypeStateIssuer
8F4900OtherBLUE CROSS BLUE SHIELD
2664613OtherTXAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120424000105 TX Practitioner - Chiropractic 6709048507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21115 N Hwy 281
Suite 1502
San Antonio, TX 78258-7634
Phone (210) 402-6633

21115 US Hwy 281 N
Suite 1502
San Antonio, TX 78258-7634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC6997TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Chiropractic and Injury Clinic, P.a. Chiropractor CurrentSince Feb 1, 2002 Accepting new patients
Diagnostic and Natural Health Center, P.a. Chiropractor Past Accepting new patients

Locations

7330 San Pedro Ave
Ste 120
San Antonio, TX 78216
Phone (210) 342-4000

21115 US Highway 281 N
Ste 1502
San Antonio, TX 78258
Phone (210) 402-6633

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1720155526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21115 N HWY 281",
            "address_2": "STE 1502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587634",
            "telephone_number": "210-342-4000",
            "fax_number": "210-342-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO AVE",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78216",
            "telephone_number": "210-342-4000",
            "fax_number": "210-342-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "STEVEN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "6997",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC6997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8F4900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2664613",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.