Active NPI
Steven David Grob, D.C.
- Chiropractor
- Groton, CT
National Provider Identifier
1861415556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 000397
- Practice address
- 1057 Poquonnock Rd
Groton, CT 06340-4220 - Phone
- (860) 445-4148
- Fax
- (860) 449-1375
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 000397 | CT | Primary |
Addresses
Primary practice location
1057 Poquonnock Rd
Groton, CT 06340-4220
Mailing address
1057 Poquonnock Rd
Groton, CT 06340-4220
Phone (860) 445-4148
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070213 | Other | CT | ACN |
| 1031257 | Other | CT | ASHN |
| 05000397CT01 | Other | CT | ANTHEM BLUE CROSS |
| 10443909 | Other | CT | CAQH |
| NLS066 | Other | CT | TRIAD/OXFORD |
| OV4644 | Other | CT | LANDMARK/HEALTHNET |
| 4569279 | Other | CT | AETNA |
| 44-00115 | Other | CT | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000397 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861415556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1057 POQUONNOCK RD",
"city": "GROTON",
"state": "CT",
"postal_code": "063404220",
"telephone_number": "860-445-4148",
"fax_number": "860-449-1375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1057 POQUONNOCK RD",
"city": "GROTON",
"state": "CT",
"postal_code": "063404220",
"telephone_number": "860-445-4148",
"fax_number": "860-449-1375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROB",
"first_name": "STEVEN",
"middle_name": "DAVID",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "000397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN",
"identifier": "070213",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHN",
"identifier": "1031257",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "05000397CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "10443909",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIAD/OXFORD",
"identifier": "NLS066",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LANDMARK/HEALTHNET",
"identifier": "OV4644",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4569279",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "44-00115",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.