NPIMap

Organization Active NPI

Dianne M. Grejtak

Doing business as Medical Specialty Shoppe

  • Durable Medical Equipment & Medical Supplies
  • San Antonio, TX
National Provider Identifier
1891872719
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0065742 Issued in TX
Legal business name
DIANNE M. GREJTAK
Doing business as
Medical Specialty Shoppe
Practice address
4944 Research Dr
San Antonio, TX 78240-5006
Phone
(210) 614-3360
Fax
(210) 614-3362
NPI assigned
Nov 1, 2006
Last updated
Aug 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Authorized official

Name
Ms. Dianne M. Grejtak
Title
Owner
Phone
(210) 614-3360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0065742 TX Primary
Oxygen Equipment & Supplies (DME) 332BX2000X 0065742 TX

Addresses

Primary practice location

4944 Research Dr
San Antonio, TX 78240-5006

Mailing address

4944 Research Dr
San Antonio, TX 78240-5006
Phone (210) 614-3360

Other identifiers 8

IdentifierTypeStateIssuer
190990121250OtherTXHUMANA
155364601MedicaidTX
155364602MedicaidTX
531788OtherTXBCBS FEDERAL
4037010OtherTNBCBS TN
531788OtherTXBCBS TX
0007451364OtherTXAETNA TRS
585599OtherTXBCBS KS

Other names 1

  • Medical Specialty Shoppe Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1891872719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944 RESEARCH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405006",
            "telephone_number": "210-614-3360",
            "fax_number": "210-614-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4944 RESEARCH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405006",
            "telephone_number": "210-614-3360",
            "fax_number": "210-614-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANNE M. GREJTAK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "GREJTAK",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-614-3360",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0065742",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "0065742",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "190990121250",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155364601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155364602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEDERAL",
            "identifier": "531788",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4037010",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "531788",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA TRS",
            "identifier": "0007451364",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KS",
            "identifier": "585599",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Specialty Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.