Organization Active NPI

100 Chiropractic Grant SE Inc

  • Chiropractor
  • San Marcos, CA
National Provider Identifier
1871483289
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
100 CHIROPRACTIC GRANT SE INC
Practice address
1217 San Elijo Rd S Ste 101
San Marcos, CA 92078-1172
Phone
(209) 498-4085
NPI assigned
Jul 7, 2025
Last updated
Oct 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Jacqueline Grant, DCNPI 1700178837
Title
Owner
Phone
(858) 524-1091

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

1217 San Elijo Rd S Ste 101
San Marcos, CA 92078-1172

Mailing address

20551 N Pima Rd Ste 100
Scottsdale, AZ 85255-9154

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251031003913 CA Part B Supplier - Clinic/Group Practice 0345739959 Receives reassigned benefits from 1 practitioner
Practice locations: San Marcos, CA

National Provider Directory

National Provider Directory

Locations

1217 San Elijo Rd S
San Marcos, CA 92078

1217 San Elijo Rd S
Ste 101
San Marcos, CA 92078
Phone (209) 498-4085

1217 San Elijo Rd S
Ste 1A
San Marcos, CA 92078
Phone (209) 498-4085

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1871483289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20551 N PIMA RD STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852559154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 SAN ELIJO RD S STE 101",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781172",
            "telephone_number": "209-498-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "100 CHIROPRACTIC GRANT SE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-524-1091",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.