Individual provider Active NPI

Theresa Joan Gromala, DC

  • Occupational Health Chiropractor
  • Bloomington, MN
National Provider Identifier
1881853836
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
2278 Issued in MN
Practice address
2200 W 89TH St
Bloomington, MN 55431-2007
Phone
(612) 599-9625
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X 2278 MN Primary
Research Study Specialist 1744R1102X

Addresses

Primary practice location

2200 W 89TH St
Bloomington, MN 55431-2007

Mailing address

2200 W 89TH St
Bloomington, MN 55431-2007
Phone (612) 599-9625

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1881853836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W 89TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312007",
            "telephone_number": "612-599-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W 89TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312007",
            "telephone_number": "612-599-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROMALA",
        "first_name": "THERESA",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "MN",
            "license": "2278",
            "primary": true
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

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