Individual provider Active NPI

Joshua Ardell Grammer, D.C.

  • Chiropractor
  • Derby, KS
National Provider Identifier
1750676045
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05413 Issued in KS
Practice address
620 N Baltimore Ave
Suite B
Derby, KS 67037-1640
Phone
(316) 788-7500
Fax
(316) 788-7702
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05413 KS Primary

Addresses

Primary practice location

620 N Baltimore Ave
Suite B
Derby, KS 67037-1640

Mailing address

620 N Baltimore Ave
Suite B
Derby, KS 67037-1640
Phone (316) 788-7500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723000038 NE Practitioner - Chiropractic 7113185125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Subluxation 1 LLCGroup PAC ID 5496080574, 2 clinicians

Practice addresses (Care Compare)

208 S Burlington Ave
103A Active Family Chiropractic and Acupunctu
Hastings, NE 68901-5943
Phone (402) 249-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05413KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pomeroy Chiropractic Wellness P.a. Chiropractor PastSince Jul 23, 2004 Accepting new patients
Shaw Chiropractic LLC Chiropractor PastSince Feb 1, 2022 Accepting new patients
All Star Chiropractic, Inc. Chiropractor Past Accepting new patients

Organizations & group practices 5

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1750676045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N BALTIMORE AVE",
            "address_2": "SUITE B",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670371640",
            "telephone_number": "316-788-7500",
            "fax_number": "316-788-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N BALTIMORE AVE",
            "address_2": "SUITE B",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670371640",
            "telephone_number": "316-788-7500",
            "fax_number": "316-788-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMMER",
        "first_name": "JOSHUA",
        "middle_name": "ARDELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.