Wayne Alden Grisso III, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

713593 Issued in OR

Practice address

2200 Morriss Rd
Suite 200
Flower Mound, TX 75028-3598

Phone

(972) 874-7554

Fax

(972) 874-7553

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Trace Grisso Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Denton Chiropractic Center, Inc

  dba Lewisville Chiropractic Center

  • Chiropractor
  • Denton, TX
  • NPI 1326053737
  NPD (past)
• Back to Health Chiropractic Alliance, LLC

  • Chiropractor
  • Klamath Falls, OR
  • NPI 1235173196
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1811938756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10016 CHERRY HILL LN",
            "city": "PROVIDENCE VILLAGE",
            "state": "TX",
            "postal_code": "762278550",
            "telephone_number": "405-620-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MORRISS RD",
            "address_2": "SUITE 200",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283598",
            "telephone_number": "972-874-7554",
            "fax_number": "972-874-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSO",
        "first_name": "WAYNE",
        "middle_name": "ALDEN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "713593",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "651163168",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACE",
            "last_name": "GRISSO",
            "prefix": "DR.",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Greenside 25 Incorporated (Compassionate Connections)
• Mackenzie Greer
• Olesya Bodyu Griffith, FNP-C
• Rachel Elizabeth Grim
• Kristyn Grisko, LPC
• Hollis A Groom, CNM
• Marsha Gross, APRN, CNM, MSN
• Kerin K. Groves, PHD, LPC-S
• Grow With Greene, PT
• Karen Guerrero

• Chiropractor in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.