Organization Active NPI

Julie Reddell Gruben DC PLLC

  • Chiropractor
  • Allen, TX
National Provider Identifier
1972816049
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11448 Issued in TX
Legal business name
JULIE REDDELL GRUBEN DC PLLC
Practice address
515 W Main St
Suite 101
Allen, TX 75013-8000
Phone
(972) 908-3322
Fax
(972) 908-3341
NPI assigned
Jul 19, 2010
Last updated
Nov 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Authorized official

Name
Dr. Julie Reddell Gruben, D.C.NPI 1770801334
Title
Owner
Phone
(972) 908-3322

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 11448 TX Primary

Addresses

Primary practice location

515 W Main St
Suite 101
Allen, TX 75013-8000

Mailing address

515 W Main St
Suite 101
Allen, TX 75013-8000
Phone (972) 908-3322

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130722000315 TX Part B Supplier - Clinic/Group Practice 7618118472 Receives reassigned benefits from 3 practitioners
Practice locations: Allen, TX

National Provider Directory

National Provider Directory

Locations

515 W Main St
Ste 102
Allen, TX 75013
Phone (972) 747-5077

Practitioners & affiliated clinicians

Practitioners 4

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": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1972816049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W MAIN ST",
            "address_2": "SUITE 101",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138000",
            "telephone_number": "972-908-3322",
            "fax_number": "972-908-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W MAIN ST",
            "address_2": "SUITE 101",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138000",
            "telephone_number": "972-908-3322",
            "fax_number": "972-908-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE REDDELL GRUBEN DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "GRUBEN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "REDDELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-908-3322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.