Individual provider Active NPI

Jason Grimard

  • Rehabilitation Chiropractor
  • Quincy, MA
National Provider Identifier
1982180741
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
3620 Issued in MA
Practice address
45 Virginia Rd
Quincy, MA 02169-2425
Phone
(413) 834-8897
NPI assigned
Jul 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 3620 MA Primary

Addresses

Primary practice location

45 Virginia Rd
Quincy, MA 02169-2425

Mailing address

45 Virginia Rd
Quincy, MA 02169-2425
Phone (413) 834-8897

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180912002946 MA Practitioner - Chiropractic 4183974157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 Oak St
Beverly, MA 01915-2230
Phone (413) 834-8897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3620MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grimard Chiropractic Single Specialty CurrentSince Jun 15, 2023 Accepting new patients
Koenig Family Chiropractic, Inc Single Specialty CurrentSince Aug 13, 2018 Accepting new patients

Locations

20 Oak St
Beverly, MA 01915
Phone (413) 834-8897

85 Samoset St
Plymouth, MA 02360
Phone (508) 746-5899

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1982180741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 VIRGINIA RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692425",
            "telephone_number": "413-834-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 VIRGINIA RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692425",
            "telephone_number": "413-834-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMARD",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MA",
            "license": "3620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.