Organization Active NPI

Griswold Chiropractic

  • Chiropractor
  • Monticello, GA
National Provider Identifier
1801018288
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6912 Issued in GA
Legal business name
GRISWOLD CHIROPRACTIC
Practice address
111 W. Washington St
Monticello, GA 31064
Phone
(706) 468-6500
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen R Griswold, D.C.NPI 1629189212
Title
Chiropractor
Phone
(706) 468-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 6912 GA Primary

Addresses

Primary practice location

111 W. Washington St
Monticello, GA 31064

Mailing address

P. O. Box 636
Monticello, GA 31064

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000354 GA Part B Supplier - Clinic/Group Practice 6507750734 Receives reassigned benefits from 1 practitioner
Practice locations: Gray, GA

National Provider Directory

National Provider Directory

Locations

111 Atlanta Rd
Gray, GA 31032
Phone (478) 250-1331

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801018288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 636",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "31064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W. WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "31064",
            "telephone_number": "706-468-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRISWOLD CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRISWOLD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "706-468-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "6912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.