Disc Center of Port St Lucie LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DISC CENTER OF PORT ST LUCIE LLC

Practice address

555 NW Lake Whitney PL Ste 105
Port St Lucie, FL 34986-1623

Phone

(772) 237-2080

NPI assigned

Oct 19, 2022

Last updated

Dec 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Grassam, DCNPI 1821293440

Title

Manager

Phone

(772) 237-2080

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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.

• John Grassam, D.C.

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1821293440
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1992421002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 NW LAKE WHITNEY PL STE 105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 NW LAKE WHITNEY PL STE 105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861623",
            "telephone_number": "772-237-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISC CENTER OF PORT ST LUCIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "GRASSAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "772-237-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.