Individual provider Active NPI

Blake McGrath

  • Chiropractor
  • Columbia, MO
National Provider Identifier
1770020844
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017002289 Issued in MO
Practice address
3700 I 70 Dr SE Ste 110
Columbia, MO 65201-6587
Phone
(573) 443-1414
NPI assigned
Jan 26, 2017
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2017002289 MO Primary

Addresses

Primary practice location

3700 I 70 Dr SE Ste 110
Columbia, MO 65201-6587

Mailing address

3700 I 70 Dr SE Ste 110
Columbia, MO 65201-6587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170215001705 MO Practitioner - Chiropractic 5991088056 Reassigns benefits to 1 organization
I20220926003665 IL Practitioner - Chiropractic 5991088056

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 E Battlefield St
Springfield, MO 65807-4804
Phone (417) 887-0340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
180 Health Lifestyle Wellness Centers Chiropractor CurrentSince Mar 1, 2025 Accepting new patients
180 Health Lifestyle Wellness Centers PastSince Mar 1, 2025 Accepting new patients

Locations

500 E Battlefield St
Springfield, MO 65807
Phone (417) 887-0340

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, 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": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1770020844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 I 70 DR SE STE 110",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 I 70 DR SE STE 110",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016587",
            "telephone_number": "573-443-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRATH",
        "first_name": "BLAKE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017002289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.